Cefadroxil

Cefadroxil belongs to the pharmacological class of first-generation cephalosporin antibiotics.

Cefadroxil has been approved to relieve symptoms and also for the treatment and maintenance of prosthetic joint infection, staphylococci, chronic oral antimicrobial suppression, skin, and soft tissue infection, streptococcal pharyngitis, group A, urinary tract infection, impetigo (pediatric), osteoarticular infection, acute (pediatric)

Cefadroxil is well absorbed in the Gastrointestinal tract without food interaction. Cefadroxil is excreted unchanged in the urine. Cefadroxil eliminated 90% of the urine in 24 hours.

The common side effects involving the use of Cefadroxil are nausea, vomiting, gas, weakness, tiredness, itching, diarrhea, headache,upset stomach, etc.

Cefadroxil is available in the form of Capsules, Tablets, and suspension reconstituted.

Cefadroxil is approved in the U.S., U.K., Germany, Japan, Malaysia, India, and China.

Cefadroxil belongs to the pharmacological class of first-generation cephalosporin antibiotics.

Cefadroxil is a cephalosporin antibiotic, a class of β-lactam antibiotics similar to penicillins, which binds to and inhibits penicillin-binding proteins (PBPs). Cefadroxil binds to specific penicillin-binding proteins (PBPs) which are located inside the bacterial cell wall. Cefadroxil inhibits the third and last stage of bacterial cell wall synthesis. Hence , the Cell lysis is then mediated by the bacterial cell wall autolytic enzymes such as autolysins.

Cefadroxil has been approved to relieve symptoms and also for the treatment and maintenance of prosthetic joint infection, staphylococci, chronic oral antimicrobial suppression,skin and soft tissue infection, streptococcal pharyngitis, group A, urinary tract infection, impetigo (pediatric), osteoarticular infection, acute (pediatric).

Cefadroxil is found to be available in the form of Capsules, Tablets and suspension reconstituted.

Cefadroxil can be used in the following treatment:

• Prosthetic joint infection, staphylococci, chronic oral antimicrobial suppression
• Skin and soft tissue infection
• Streptococcal pharyngitis, group A
• Urinary tract infection
• Impetigo (pediatric)
• Osteoarticular infection, acute (pediatric)

Cefadroxil can help to relieve symptoms and also for the treatment and maintenance of prosthetic joint infection, staphylococci, chronic oral antimicrobial suppression,skin and soft tissue infection, streptococcal pharyngitis, group A, urinary tract infection, impetigo (pediatric), osteoarticular infection, acute (pediatric)

Cefadroxil is approved for use in the following clinical indications:

● Prosthetic joint infection, staphylococci, chronic oral antimicrobial suppression

● Skin and soft tissue infection

● Streptococcal pharyngitis, group A

● Urinary tract infection

● Impetigo (pediatric)

● Osteoarticular infection, acute (pediatric)

Capsules, Tablet : to be taken as a whole with water

Suspension reconstituted : To be taken orally

Prosthetic joint infection, staphylococci, chronic oral antimicrobial suppression :

500 mg every 12 hours

Skin and soft tissue infection:

Cellulitis (nonpurulent)/erysipelas, mild, treatment (alternative agent): Oral: 1 g once daily or 500 mg twice daily for 5 days

Cellulitis, long-term suppression of recurrent infection: 500 mg twice daily after completion of treatment

Streptococcal pharyngitis, group A:

1 g once daily for 10 days

Urinary tract infection:

Cystitis, acute uncomplicated or acute simple cystitis : 500 mg two times a day for 5 to 7 days

Urinary tract infection, complicated (including pyelonephritis): Oral: 1 g twice daily for 10 to 14 days

Capsule, Suspension Reconstituted ,Tablet

• Dosage Adjustments in Kidney Patients

Cefadroxil should be administered cautiously in the presence of impaired renal function i.e.creatinine clearance < 30 mL/min, with or without dialysis).

• Dosage Adjustments in Pediatric Patients:

Impetigo: 30 mg/kg/day once daily or in divided doses every 12 hours

Osteoarticular infection, acute: 75 to 150 mg/kg/day divided into doses every 6 to 8 hours

Skin and soft tissue infections: 30 mg/kg/day in divided doses every 12 hours

Streptococcus, group A; pharyngitis/tonsillitis: 30 mg/kg/day once daily or in divided doses every 12 hours for 10 days

Urinary tract infections: 30 mg/kg/day divided every 12 hours.

Avoid high acid foods like citrus fruits and juices like orange and grapefruit, soda and chocolates.

Alcohol intake might lead to nausea,vomiting and headache

Multivitamins and antacids contain minerals primarily magnesium calcium aluminum iron or zinc which binds to the antibiotic and refrain it from working. Spacing them at least for 2 hours after Cefadroxil administration is recommended.

Cefadroxil may be contraindicated under the following conditions:

• Patients with known hypersensitivity to cephalosporins.

The physician should closely monitor the patients and keep pharmacovigilance as follows:

• Hypersensitivity Reactions

Allergic reactions such as rash, urticaria, angioedema, anaphylaxis, erythema multiforme, Stevens-Johnson syndrome/ toxic epidermal necrolysis had been reported with the use of Cefadroxil. It is advised that before therapy with Cefadroxil is to be instituted, inquire whether the patient has a history of hypersensitivity reactions to Cefadroxil, cephalosporins, penicillins, or other drugs. Cross-hypersensitivity among beta-lactam antibacterial drugs might occur in up to 10% of patients having a history of penicillin allergy. If an allergic reaction to Cefadroxil occurs, it is advised to discontinue the drug and institute appropriate treatment.

• Clostridium difficile-Associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) had been reported with use of nearly all antibacterial agents, including Cefadroxil, and might range in severity from mild diarrhea to a fatal colitis. Treatment with antibacterial agents is said to alter the normal flora of the colon in turn leading to

overgrowth of C. difficile. C. difficile also produces toxins A and B, which contribute to the development of Clostridium difficile-associated diarrhea Hyper Toxin-producing strains of C. difficile caused increased morbidity as well as mortality, as these infections can be refractory to antimicrobial therapy and might require colectomy. Clostridium difficile-associated diarrhea must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since Clostridium difficile-associated diarrhea had been

reported to occur over 2 months after the administration of antibacterial agents.

Usage of alcohol should be avoided while on Cefadroxil medication, as alcohol can worsen the effects of any underlying disease condition, including conditions such as dizziness, blurred vision, etc.

It is advised that caution should be exercised when cefadroxil monohydrate is being administered to a nursing mother.

Pregnancy Category B

Reproduction studies had been performed in mice and rats at doses up to eleven times the human dose and no evidence of impaired fertility or harm to the fetus due to cefadroxil monohydrate had been revealed. There are, found to be , no adequate and well controlled studies in pregnant women. As the animal reproduction studies are not always predictive of human response, cefadroxil should be used during pregnancy only if clearly needed.

No sufficient scientific evidence is traceable regarding the use and safety of Cefadroxil in concurrent use with any particular food.

The adverse reactions related to Cefadroxil can be categorized as follows:

Common

• Diarrhea
• Unusual or unpleasant taste in your mouth
• Itching or skin rash
• Stiff or tight muscles
• Joint pain
• Vaginal itching or discharge
• Stomach upset or pain
• Nausea
• Vomiting
• Feeling restless or hyperactive

Rare

• Fever with or without chills
• Flushing or redness of the skin
• General feeling of tiredness or weakness
• Headache
• Vomiting
• Yellow eyes or skin
• Inflammation of the joints
• Itching
• Joint or muscle pain
• Light-colored stools
• Black, tarry stools
• Bleeding gums
• Diarrhea
• Difficulty with moving
• Feeling of discomfort
• Fever
• Sores, ulcers, or white spots on the lips or in the mouth
• Stomach pain, continuing
• Swollen lymph glands
• Rash
• Red skin lesions, often with a purple center
• Lower back or side pain
• Muscle aches
• Muscle pain or stiffness
• Painful or difficult urination
• Pinpoint red spots on the skin
• Red, irritated eyes
• Sore throat
• Blistering, peeling, or loosening of the skin
• Blood in the urine or stools
• Chills
• Clay-colored stools
• Cough or hoarseness
• Dark-colored urine
• Unusual bleeding or bruising
• Unusually warm skin

The clinically relevant drug interactions of Cefadroxil is briefly summarized here:

Lactobacillus and Estriol: Antibiotics might diminish the therapeutic effect of Lactobacillus and Estriol.

Aminoglycosides: Cephalosporins may enhance the nephrotoxic effect of Aminoglycosides. Cephalosporins may decrease the serum concentration of Aminoglycosides.

Bacillus clausii: Antibiotics might diminish the therapeutic effect of Bacillus clausii. Management: It is advised that Bacillus clausii should be taken in between the antibiotic doses during concomitant therapy.

BCG (Intravesical): Antibiotics might diminish the therapeutic effect of BCG (Intravesical).

BCG Vaccine (Immunization): Antibiotics might diminish the therapeutic effect of BCG Vaccine (Immunization).

Cholera Vaccine: Antibiotics might diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients who are receiving systemic antibiotics, and within fourteen days following the use of oral or parenteral antibiotics.

Furosemide: Might enhance the nephrotoxic effect of Cephalosporins.

Immune Checkpoint Inhibitors: Antibiotics might diminish the therapeutic effect of the Immune Checkpoint Inhibitors.

Probenecid: Might increase the serum concentration of Cephalosporins.

Sodium Picosulfate: Antibiotics might diminish the therapeutic effect of Sodium Picosulfate.

Management: It is advised to consider using an alternative product for the bowel cleansing prior to a colonoscopy in patients who had recently used or are concurrently using an antibiotic.

Typhoid Vaccine: Antibiotics might diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is found to be affected. Management: Avoid using live attenuated typhoid vaccine (Ty21a) in patients being treated with the systemic antibacterial agents. It is advised to postpone vaccination until three days after cessation of antibiotics and avoid starting antibiotics within three days of last vaccine dose.

Vitamin K Antagonists (eg, warfarin): Cephalosporins might enhance the anticoagulant effect of Vitamin K Antagonists.

The following are the side effects involving Cefadroxil :

● Diarrhea

● Unusual or unpleasant taste in your mouth

● Itching or skin rash

● Stiff or tight muscles

● Joint pain

● Vaginal itching or discharge

● Stomach upset or pain

● Nausea

● Vomiting

● Feeling restless or hyperactive

• Pregnancy

Pregnancy Category B

Reproduction studies had been performed in mice and rats at doses up to elevan times the human dose and no evidence of impaired fertility or harm to the fetus due to cefadroxil monohydrate had been revealed. There are, found to be , no adequate and well controlled studies in pregnant women. As the animal reproduction studies are not always predictive of human response, cefadroxil should be used during pregnancy only if clearly needed.

• Lactation

It is advised that caution should be exercised when cefadroxil monohydrate is being administered to a nursing mother.

• Pediatric

It is recommended for use in skin soft tissue infections, impetigo as stated above.

• Geriatric

There has found to be no overall differences in safety had been observed between the elderly patients and younger patients. Clinical studies for the treatment of pharyngitis/ tonsillitis did not include sufficient numbers of patients aged 65 years and older in order to determine whether the elderly population respond differently from younger patients. Other reported clinical experience with cefadroxil had not identified differences in responses between elderly as well as younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Physicians should be knowledgeable and vigilant about the treatment and identification of overdosage of Cefadroxil.

No specific action is required other than general support and observation.

Pharmacodynamics

Cefadroxil, is said to be a first-generation cephalosporin antibiotic, which is indicated to treat urinary tract infections, skin and skin structure infections, pharyngitis, as well as tonsillitis.

Pharmacokinetics

• Absorption

Cefadroxil is found to be well absorbed on oral administration as food does not interfere with its absorption.

• Route of elimination

Over 90% of the drug is found to be excreted unchanged in the urine within 24 hours. Cefadroxil had been detected in the placenta and breast milk.

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