What is the recommended dose of Cefradroxil (Cefradroxil) for treating cellulitis?

Recommended Dosage of Cefradroxil for Cellulitis

For cellulitis treatment, the recommended dose of cefradroxil is 1 gram per day, administered either as a single daily dose or divided into two doses (500 mg twice daily). 1

Dosing Guidelines for Cefradroxil in Cellulitis

Adult Dosing

• Standard dose: 1 gram per day 1
• Administration options:
  • 1 gram once daily (q.d.)
  • 500 mg twice daily (b.i.d.)
• Duration: 5-10 days, with 5 days being sufficient for most uncomplicated cases 2

Pediatric Dosing

• 30 mg/kg/day in equally divided doses every 12 hours 1
• For children with skin and skin structure infections including cellulitis

Dosage Adjustment in Renal Impairment

Cefradroxil requires dose adjustment based on creatinine clearance:

• Normal renal function (>50 mL/min): Standard dosing
• Moderate impairment (25-50 mL/min): 500 mg every 12 hours
• Severe impairment (10-25 mL/min): 500 mg every 24 hours
• Very severe impairment (<10 mL/min): 500 mg every 36 hours 1

Clinical Considerations

Efficacy and Evidence

Cefradroxil has demonstrated efficacy in treating skin and soft tissue infections including cellulitis. Research has shown that cefradroxil 1 gram per day is therapeutically equivalent to cephalexin 250 mg four times daily in treating facial cellulitis 3. This once or twice daily dosing provides a significant advantage for patient adherence compared to medications requiring more frequent administration.

Treatment Duration

The 2014 IDSA guidelines recommend a 5-day course of antibiotics for cellulitis, which can be extended if the infection has not improved within this timeframe 2. This shorter duration is supported by recent evidence and is adequate for most uncomplicated cases of cellulitis.

Antimicrobial Coverage

Cefradroxil, as a first-generation cephalosporin, is primarily effective against streptococci, which are the most common causative organisms in non-purulent cellulitis 2. For typical cases of cellulitis without systemic signs of infection, an antimicrobial agent active against streptococci is recommended 2.

When to Consider Alternative Therapy

Consider alternative therapy in the following situations:

• Purulent cellulitis (may need coverage for MRSA)
• Cellulitis associated with penetrating trauma
• Evidence of MRSA infection elsewhere
• Nasal colonization with MRSA
• Injection drug use
• Presence of systemic inflammatory response syndrome (SIRS)
• Failure to respond to initial therapy 2

Practical Recommendations

1. Administer cefradroxil without regard to meals, though taking with food may help reduce gastrointestinal complaints 1
2. Ensure a full 5-day course at minimum, extending if clinical improvement is not observed 2
3. Elevate the affected area and treat predisposing factors such as edema or underlying skin disorders 2
4. For lower extremity cellulitis, examine interdigital toe spaces for fissuring, scaling, or maceration that may harbor pathogens 2
5. Monitor for clinical response within the first 2-3 days of therapy

Cefradroxil's once or twice daily dosing schedule improves patient adherence compared to antibiotics requiring more frequent administration, which is a significant advantage in outpatient management of cellulitis 3.