What is the recommended dosing for Cefadroxil (Cefadroxil) suppression therapy?

From the Guidelines

Cefadroxil suppression therapy is recommended at a dose of 30 mg/kg once daily, with a maximum dose of 1 g, for a duration of 10 days. This recommendation is based on the clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America 1. The guideline provides strong, high-quality evidence for the use of cefadroxil as an alternative to other antibiotics for the treatment of group A streptococcal pharyngitis. Key points to consider when prescribing cefadroxil suppression therapy include:

• The dose should be adjusted based on the patient's weight, with a maximum dose of 1 g per day.
• The duration of therapy is typically 10 days, but may vary depending on the clinical situation.
• Cefadroxil is generally well-tolerated, but patients should be monitored for allergic reactions, especially if they have a history of penicillin allergy.
• Regular follow-up is recommended to assess efficacy and the need for continued therapy. It's worth noting that while the provided guideline focuses on group A streptococcal pharyngitis, the principles of antibiotic dosing can be applied to other contexts where cefadroxil is used for suppression therapy, such as recurrent urinary tract infections, although the specific dosing and duration may vary based on the clinical context and other guidelines 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Cefadroxil for oral suspension is acid-stable and may be administered orally without regard to meals. Adults Urinary Tract Infections For uncomplicated lower urinary tract infections (i.e., cystitis) the usual dosage is 1 or 2 g per day in a single (q.d.) or divided doses (b.i.d.). For all other urinary tract infections the usual dosage is 2 g per day in divided doses (b.i.d.). Skin and Skin Structure Infections For skin and skin structure infections the usual dosage is 1 g per day in single (q.d.) or divided doses (b.i.d.) Pharyngitis and Tonsillitis Treatment of group A beta-hemolytic streptococcal pharyngitis and tonsillitis— 1 g per day in single (q.d.) or divided doses (b.i.d.) for 10 days.

The recommended dosing for Cefadroxil suppression therapy is not explicitly stated in the provided drug label. However, based on the available information, the usual dosage for urinary tract infections and skin and skin structure infections can be considered.

• For uncomplicated lower urinary tract infections, the dosage is 1 or 2 g per day in a single or divided doses.
• For all other urinary tract infections, the dosage is 2 g per day in divided doses.
• For skin and skin structure infections, the dosage is 1 g per day in single or divided doses. It is essential to note that the term "suppression therapy" is not directly mentioned in the label, and therefore, the dosing recommendations provided may not be directly applicable to suppression therapy. 2

From the Research

Cefadroxil Suppression Dosing

The recommended dosing for Cefadroxil suppression therapy varies depending on the specific condition being treated.

• For urinary tract infections, a dose of 1,000 mg twice daily has been shown to be effective 3, 4.
• For skin and soft tissue infections, doses of 0.6-1.8 g per day given on twice or three times daily schedules have been used 5.
• In children with urinary tract infections, a dose of 25 mg/kg administered once daily has been compared to ampicillin 6.
• A controlled comparison of high-compliance oral dosage regimens for urinary tract infections found that 2,000 mg once daily, 1,000 mg once daily, or 1,000 mg twice daily were all effective 4.
• A review of cephalexin and cefadroxil for the treatment of acute uncomplicated lower urinary tract infections suggests that cefadroxil can be conveniently administered as 500 mg twice daily 7.

Dosage Considerations

When considering the dosage of Cefadroxil for suppression therapy, it is essential to take into account the specific condition being treated, as well as the patient's age, weight, and renal function.

• The dosage may need to be adjusted in patients with impaired renal function.
• Cefadroxil has been shown to be effective in a variety of dosage regimens, including twice daily and once daily schedules.
• The choice of dosage regimen may depend on the specific clinical situation and the patient's ability to comply with the treatment regimen.

Clinical Efficacy

Cefadroxil has been shown to be clinically effective in the treatment of various infections, including urinary tract infections and skin and soft tissue infections.

• The efficacy of Cefadroxil has been compared to other antibiotics, such as cephalexin and ampicillin.
• Cefadroxil has been found to be as effective as these other antibiotics in many cases 3, 5, 6.
• The clinical efficacy of Cefadroxil may depend on the specific dosage regimen used, as well as the patient's individual characteristics.