No

Antibiotic, Cephalosporin (First Generation)

Dental: Alternative antibiotic for prevention of bacterial endocarditis. Individuals allergic to amoxicillin (penicillins) may receive cefadroxil provided they have not had an immediate, local, or systemic IgE-mediated anaphylactic allergic reaction to penicillin.

Medical: Treatment of susceptible bacterial infections, including those caused by group A beta-hemolytic Streptococcus; prophylaxis against bacterial endocarditis in patients who are allergic to penicillin and undergoing surgical or dermal procedures

B

Hypersensitivity to cefadroxil or other cephalosporins

Modify dosage in patients with severe renal impairment; prolonged use may result in superinfection; use with caution in patients with a history of penicillin allergy especially IgE-mediated reactions (eg, anaphylaxis, urticaria); may cause antibiotic-associated colitis or colitis secondary to C. difficile

1% to 10%: Gastrointestinal: Diarrhea

<1%: Anaphylaxis, rash (maculopapular and erythematous), erythema multiforme, Stevens-Johnson syndrome, serum sickness, arthralgia, urticaria, pruritus, angioedema, pseudomembranous colitis, abdominal pain, dyspepsia, nausea, vomiting, elevated transaminases, cholestasis, vaginitis, neutropenia, agranulocytosis, thrombocytopenia, fever

Reactions reported with other cephalosporins include toxic epidermal necrolysis, abdominal pain, superinfection. renal dysfunction, toxic nephropathy, aplastic anemia, hemolytic anemia, hemorrhage, prolonged prothrombin time, increased BUN, increased creatinine, eosinophilia, pancytopenia, seizures

After acute overdose, most agents cause only nausea, vomiting, and diarrhea, although neuromuscular hypersensitivity and seizures are possible, especially in patients with renal insufficiency; many beta-lactam antibiotics have the potential to cause neuromuscular hyperirritability or seizures

Hemodialysis may be helpful to aid in the removal of the drug from the blood but not usually indicated, otherwise most treatment is supportive or symptom directed following GI decontamination

Increased effect: Probenecid may decrease cephalosporin elimination

Increased toxicity: Furosemide, aminoglycosides may be a possible additive to nephrotoxicity

Refrigerate suspension after reconstitution; discard after 14 days

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Absorption: Oral: Rapid and well absorbed from GI tract

Distribution: Widely distributed throughout the body and reaches therapeutic concentrations in most tissues and body fluids, including synovial, pericardial, pleural, and peritoneal fluids; also bile, sputum, and urine; also bone, the myocardium, gallbladder, skin and soft tissue; crosses the placenta and appears in breast milk

Protein binding: 20%

Half-life: 1-2 hours; 20-24 hours in renal failure

Time to peak serum concentration: Within 70-90 minutes

Elimination: >90% of dose excreted unchanged in urine within 8 hours

Oral:

Adults: 1-2 g/day in 2 divided doses

Prophylaxis against bacterial endocarditis: 2 g 1 hour prior to the procedure

Dosing interval in renal impairment:

Cl_cr 10-25 mL/minute: Administer every 24 hours

Cl_cr <10 mL/minute: Administer every 36 hours

Concomitant administration with food, infant formula, or cow's milk does not significantly affect absorption

Observe for signs and symptoms of anaphylaxis during first dose

Positive direct Coombs', false-positive urinary glucose test using cupric sulfate (Benedict's solution, Clinitest®, Fehling's solution), false-positive serum or urine creatinine with Jaffé reaction

May cause nervousness; case reports of euphoria, delusion, illusions, and depersonalization with cephalosporins

May rarely cause neutropenia; use caution with clozapine and carbamazepine

No information available to require special precautions

No effects or complications reported

Take as directed, at regular intervals around-the-clock (with or without food). Chilling oral suspension improves flavor (do not freeze). Complete full course of medication, even if you feel better. Drink 2-3 L fluid/day. If diarrhea occurs, yogurt or buttermilk may help. May cause false-positive test with Clinitest®; use another form of testing. May interfere with oral contraceptives; additional contraceptive measures are necessary. Report severe, unresolved diarrhea; vaginal itching or drainage; sores in mouth; blood, pus, or mucus in stool or urine; easy bleeding or bruising; unusual fever or chills; rash; or respiratory difficulty. Breast-feeding precautions: Consult prescriber if breast-feeding.

Administer around-the-clock to promote less variation in peak and trough serum levels

Capsule, as monohydrate: 500 mg

Suspension, oral, as monohydrate: 125 mg/5 mL, 250 mg/5 mL, 500 mg/5 mL (50 mL, 100 mL)

Tablet, as monohydrate: 1 g

"Advisory Statement. Antibiotic Prophylaxis for Dental Patients With Total Joint Replacements. American Dental Association; American Academy of Orthopedic Surgeons," J Am Dent Assoc, 1997, 128(7):1004-8.

Cutler RE, Blair AD, and Kelly MR, "Cefadroxil Kinetics in Patients With Renal Insufficiency," Clin Pharmacol Ther, 1979, 25(5 Pt 1):514-21.

Dajani AS, Taubert KA, Wilson W, et al, "Prevention of Bacterial Endocarditis Recommendations by the American Heart Association," JAMA, 1997, 277(22):1794-801.

Donowitz GR and Mandell GL, "Beta-Lactam Antibiotics," N Engl J Med, 1988, 318(7):419-26 and 318(8):490-500.

Marshall WF and Blair JE, "The Cephalosporins," Mayo Clin Proc, 1999, 74(2):187-95.

Smith GH, "Oral Cephalosporins in Perspective," DICP, 1990, 24(1):45-51.