cefadroxil monohydrate: clinical use

Prescribing considerations

• Confirm that the pathogen and infection site are appropriate for oral cefadroxil, considering local antimicrobial policy and resistance.
• Assess renal function because accumulation can occur with impairment.
• Review beta-lactam allergy history carefully.
• Use caution with previous colitis, severe allergy or asthma.
• It is unsuitable for meningitis because cerebrospinal-fluid penetration is inadequate.
• Consider parenteral treatment for severe or life-threatening infection.

Contraindications and cautions

• Hypersensitivity to cefadroxil, another cephalosporin or a formulation excipient
• History of a severe reaction to penicillins or another beta-lactam
• Previous cefadroxil-associated Stevens–Johnson syndrome, toxic epidermal necrolysis, DRESS or acute generalised exanthematous pustulosis

Monitoring

• Renal function where impairment is known or suspected
• For prolonged use, consider blood count and renal and hepatic function; assess for superinfection
• Coagulation during prolonged combined use with anticoagulants or antiplatelets
• Be aware of transient positive Coombs tests and falsely elevated urinary glucose with non-enzymatic methods

Clinical pharmacology

An orally absorbed first-generation cephalosporin that inhibits bacterial cell-wall synthesis. It is not metabolised and is mostly excreted unchanged in urine; elimination is delayed in renal impairment.

Formulation and product differences

• The selected product is a white, opaque hard gelatin capsule containing powder.
• Capsules should be swallowed unchewed with fluid and may be taken with or without food.
• It contains gelatin, titanium dioxide, sodium lauryl sulfate, microcrystalline cellulose and magnesium stearate, and is essentially sodium-free.
• The capsule is unsuitable for some younger children; liquid oral formulations may be needed for those unable to use capsules.

Capsule

Route: Oral

Strengths: 500 mg