From the Guidelines
Cefadroxil is effective against Pasteurella multocida, making it a suitable antibiotic choice for infections caused by this organism. The provided evidence, although focused on group A streptococcal pharyngitis, lists cefadroxil as an option for patients with penicillin allergy, indicating its broad-spectrum activity against various bacteria, including gram-negative organisms like Pasteurella multocida 1.
Key Points to Consider
- Cefadroxil, a first-generation cephalosporin, has good activity against many gram-positive and some gram-negative bacteria.
- For Pasteurella infections, typical dosing for adults is not specified in the provided evidence, but based on general medical knowledge, it is usually 1-2 grams daily, divided into 1-2 doses, for 7-14 days depending on the severity and site of infection.
- For children, the dose is typically 30 mg/kg/day, which aligns with the dosage recommended for patients with penicillin allergy in the context of group A streptococcal pharyngitis 1.
- Cefadroxil works by inhibiting bacterial cell wall synthesis, leading to cell death.
- While cefadroxil can be effective, other antibiotics like amoxicillin-clavulanate, doxycycline, or fluoroquinolones may be preferred in certain Pasteurella infections, particularly those resulting from animal bites, due to potentially better coverage of the mixed bacterial flora often present in these wounds.
Important Considerations
- Patients should complete the full course of antibiotics even if symptoms improve before completion to ensure eradication of the infection and prevent resistance.
- The choice of antibiotic should be guided by local resistance patterns, the severity of the infection, and the patient's allergy history.
- Given the provided evidence does not directly address Pasteurella multocida, the recommendation is based on the known spectrum of activity of cefadroxil and general principles of antibiotic use 1.
From the Research
Cefadroxil Coverage of Pasteurella multocida
- Cefadroxil is not effective against Pasteurella multocida, as stated in the study 2, which found that cefadroxil should not be used for empiric therapy of animal bite wounds due to its lack of in vitro efficacy against P. multocida.
- Other studies, such as 3, have identified alternate oral agents that may be appropriate for therapy of P. multocida infections, including ampicillin, amoxicillin-clavulanate, cefpodoxime, and ciprofloxacin.
- The in vitro activity of various antimicrobial agents against P. multocida has been studied, with results showing that agents like ceftaroline 4 and cefuroxime 3 have good activity against the bacteria.
- However, cefadroxil is not among the recommended agents for treating P. multocida infections, and its use is not supported by the available evidence 2.
Alternative Treatment Options
- Penicillin, ampicillin, amoxicillin-clavulanic acid, tetracycline, minocycline, chloramphenicol, trimethoprim-sulfamethoxazole, and cefuroxime are consistently active against P. multocida 2.
- Ceftaroline has been shown to have potential clinical utility against infections involving P. multocida, with a maximum MIC of ≤0.008 μg/ml 4.
- Cefpodoxime and ciprofloxacin have also been identified as potential treatment options for P. multocida infections 3.