cefadroxil
Brand: Duricef
Prototype: cephalexin
Drug Class: first-generation cephalosporin
Drug Family: antibiotic
Subclass: oral first-generation cephalosporin
Organ Systems: infectious-disease
Mechanism of Action
Inhibits bacterial cell wall synthesis by binding PBPs; bactericidal. First-generation spectrum covers gram-positive cocci and some gram-negative organisms.
penicillin-binding proteins (PBPs)
Indications
- skin and soft tissue infections
- group A streptococcal pharyngitis
- uncomplicated UTI
Contraindications
- cephalosporin hypersensitivity
- severe penicillin allergy (cross-reactivity ~1–2%)
Adverse Effects
Common
- diarrhea
- nausea
- skin rash
Serious
- anaphylaxis
- C. difficile colitis
- serum sickness-like reaction
Pharmacokinetics (ADME)
| Absorption | >90% oral bioavailability; food does not affect absorption |
| Distribution | widely distributed; poor CSF penetration |
| Metabolism | not significantly metabolized |
| Excretion | renal (unchanged); dose reduction required in CKD |
| Half-life | 1.5 hours |
| Onset | rapid |
| Peak | 1–2 hours |
| Duration | 12–24 hours |
| Protein Binding | 20% |
| Vd | moderate |
Drug Interactions
| Drug / Agent | Mechanism | Severity |
|---|---|---|
| probenecid | blocks renal tubular secretion, increasing cefadroxil levels | moderate |
| warfarin | gut flora suppression reduces vitamin K; enhanced anticoagulation | moderate |
Nursing Considerations
- May be taken with or without food; advise patients that GI upset is reduced by taking with meals.
- Assess for penicillin or cephalosporin allergy before administration; cross-reactivity is low (~1–2%) but possible.
- Monitor renal function; dose reduction is required when CrCl falls below 50 mL/min.
- Instruct patient to complete the full course even if symptoms improve.
Clinical Pearls
- Cefadroxil offers the convenience of once- or twice-daily dosing compared to cephalexin's four-times-daily regimen.
- It is an acceptable alternative to penicillin for streptococcal pharyngitis in non-anaphylactic penicillin-allergic patients.
Safety Profile
Pregnancy generally-safe
Lactation use-with-caution
Renal Adjustment Required
Hepatic Adjustment Not required
TDM Not required
Concordance Terms
Cross-referenced clinical concepts — click any term to see all content where it appears.