Cefadroxil: Effective First-Line Oral Cephalosporin Antibiotic
Cefadroxil is a broad-spectrum, first-generation cephalosporin antibiotic indicated for the treatment of bacterial infections caused by susceptible strains of microorganisms. It exerts bactericidal activity by inhibiting cell wall synthesis, making it a reliable choice for common outpatient infections. Available in oral formulations, cefadroxil offers convenient once- or twice-daily dosing, supporting adherence and clinical efficacy in both adult and pediatric populations.
Features
- Active ingredient: Cefadroxil (as monohydrate)
- Drug class: First-generation cephalosporin antibiotic
- Administration: Oral (capsules, tablets, suspension)
- Spectrum: Broad, with activity against Gram-positive and some Gram-negative bacteria
- Mechanism: Bactericidal; inhibits bacterial cell wall synthesis
- Bioavailability: Well-absorbed from the gastrointestinal tract, not significantly affected by food
- Half-life: Approximately 1.5 hours, allowing for convenient dosing schedules
- Excretion: Primarily renal; dosage adjustment required in renal impairment
Benefits
- High clinical efficacy against common pathogens such as Streptococcus pyogenes, Staphylococcus aureus, and Escherichia coli
- Convenient dosing regimen supports patient compliance and reduces missed doses
- Generally well-tolerated profile with a lower incidence of severe adverse effects compared to broader-spectrum alternatives
- Suitable for pediatric use with palatable suspension formulations
- Cost-effective option within the cephalosporin class for outpatient management
- Rapid onset of action with bactericidal effects, reducing bacterial load and symptom duration
Common use
Cefadroxil is commonly prescribed for the treatment of mild to moderate bacterial infections, including uncomplicated skin and soft tissue infections such as cellulitis, impetigo, and wound infections. It is also indicated for pharyngitis and tonsillitis caused by Group A beta-hemolytic streptococci, offering an effective alternative to penicillin in allergic patients. Additionally, cefadroxil is used for urinary tract infections caused by susceptible strains of E. coli, Proteus mirabilis, and Klebsiella species. Off-label uses may include prophylaxis in minor surgical procedures or dental extractions in at-risk individuals, though this is less common.
Dosage and direction
Dosage must be individualized based on the infection site, severity, and patient’s renal function. For adults, the typical dose for most infections is 1 to 2 grams per day, administered either once daily or in divided doses every 12 hours. For streptococcal pharyngitis, a 10-day course is recommended. Pediatric dosing is weight-based, generally 30 mg/kg/day in divided doses. In patients with renal impairment (creatinine clearance <50 mL/min), dosing intervals should be extended. Administration with or without food is acceptable, though taking with food may minimize gastrointestinal upset. Complete the full prescribed course even if symptoms improve earlier to prevent resistance.
Precautions
Use with caution in patients with a history of gastrointestinal disease, particularly colitis, as antibiotic use can predispose to Clostridium difficile-associated diarrhea. Renal function should be assessed before and during prolonged therapy; dosage adjustment is necessary in renal impairment. Monitor for superinfection or fungal overgrowth during and after treatment. In patients with a history of hypersensitivity to penicillins, cross-reactivity may occur—though the risk is low, careful observation is advised. Avoid unnecessary use to reduce the risk of antibiotic resistance. Use during pregnancy only if clearly needed; cefadroxil crosses the placenta and should be used with caution. It is excreted in breast milk; consider benefits versus potential risks in nursing mothers.
Contraindications
Cefadroxil is contraindicated in patients with known hypersensitivity to cefadroxil or any cephalosporin antibiotics. It should not be used in individuals with a history of severe, immediate hypersensitivity reactions (e.g., anaphylaxis) to penicillins or other beta-lactam antibiotics due to potential cross-reactivity. Avoid use in patients with a history of antibiotic-associated colitis. Do not administer to patients with severe renal impairment without appropriate dosage adjustment and monitoring.
Possible side effect
Common side effects include gastrointestinal disturbances such as nausea, vomiting, diarrhea, and abdominal pain. Less frequently, patients may experience headache, dizziness, or fatigue. Hypersensitivity reactions can range from mild rash and pruritus to urticaria and, rarely, anaphylaxis. Transient elevations in liver enzymes or mild, reversible neutropenia may occur. As with many antibiotics, there is a risk of Clostridium difficile-associated diarrhea, which may range from mild to life-threatening. Vaginal candidiasis or oral thrush may develop due to disruption of normal flora.
Drug interaction
Probenecid may decrease renal excretion of cefadroxil, increasing serum levels and prolonging half-life. Concurrent use with other nephrotoxic agents (e.g., aminoglycosides, loop diuretics) may enhance the risk of renal dysfunction. Cefadroxil may potentiate the effects of oral anticoagulants by reducing vitamin K-producing gut flora, increasing the risk of bleeding; monitor INR closely. Avoid concomitant use with bacteriostatic antibiotics (e.g., tetracyclines, erythromycin) as they may antagonize cefadroxil’s bactericidal effect.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of adverse effects. Maintaining consistent serum levels is important for efficacy, so patients should be advised to adhere to the prescribed regimen.
Overdose
Symptoms of cefadroxil overdose may include nausea, vomiting, epigastric distress, and diarrhea. In severe cases, neurotoxicity (e.g., seizures) may occur, particularly in patients with renal impairment. Management is supportive and symptomatic; gastric lavage or activated charcoal may be considered if ingestion was recent. Hemodialysis can remove cefadroxil from the bloodstream and may be employed in significant overdose, especially with renal compromise. Monitor renal function and provide electrolyte balance support as needed.
Storage
Store at controlled room temperature (20–25°C or 68–77°F), in a tightly closed container, and protect from light and moisture. Keep the oral suspension refrigerated after reconstitution; discard any unused portion after 14 days. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any new medication or changing your treatment plan. The efficacy and safety profile may vary based on individual patient factors. Never disregard professional medical advice or delay seeking it because of something you have read here.
Reviews
Clinical studies and post-marketing surveillance indicate that cefadroxil is generally effective and well-tolerated for approved indications. In comparative trials, it demonstrates similar efficacy to other first-generation cephalosporins and is often preferred for its convenient dosing. Patient reviews frequently highlight ease of use and minimal side effects, though gastrointestinal complaints are noted in a minority of cases. Healthcare providers appreciate its role as a cost-effective option with a reliable spectrum of activity for common community-acquired infections.