Recommended Dosage of Cefadroxil for Acute Tonsillitis

For the treatment of acute tonsillitis, the recommended dosage of cefadroxil is 30 mg/kg once daily (maximum 1 g) for 10 days. 1, 2

Dosing Guidelines

1 g per day in a single dose or divided into two doses (500 mg twice daily) for 10 days 1

30 mg/kg per day in a single dose or divided doses every 12 hours for 10 days 1, 2
For a reference guide based on weight:
- 10 lbs (4.5 kg): ½ tsp of 250 mg/5 mL suspension 1
- 20 lbs (9.1 kg): 1 tsp of 250 mg/5 mL suspension 1
- 30 lbs (13.6 kg): 1½ tsp of 250 mg/5 mL suspension 1
- 40 lbs (18.2 kg): 2 tsp of 250 mg/5 mL or 1 tsp of 500 mg/5 mL suspension 1
- 50 lbs (22.7 kg): 2½ tsp of 250 mg/5 mL or 1¼ tsp of 500 mg/5 mL suspension 1
- 60 lbs (27.3 kg): 3 tsp of 250 mg/5 mL or 1½ tsp of 500 mg/5 mL suspension 1
- 70+ lbs (31.8+ kg): 2 tsp of 500 mg/5 mL suspension 1

Penicillin V or amoxicillin remains the treatment of choice for Group A Streptococcal (GAS) pharyngitis due to proven efficacy, safety, narrow spectrum, and low cost 2, 3
Amoxicillin (50 mg/kg once daily, maximum 1000 mg) for 10 days is often preferred for children due to better taste acceptance 2, 3

Cefadroxil should be reserved for patients with penicillin allergy (except those with immediate/anaphylactic hypersensitivity) 2, 3
Narrow-spectrum cephalosporins like cefadroxil are preferred over broad-spectrum options (cefaclor, cefuroxime, cefixime, cefdinir, cefpodoxime) for penicillin-allergic patients 3

A full 10-day course is recommended for all patients with GAS pharyngitis to ensure complete eradication and prevent complications such as acute rheumatic fever 2
Studies have shown that cefadroxil once daily is as effective as cephalexin twice or three times daily for treating GAS tonsillopharyngitis 4

For patients with renal impairment, dosage adjustment is necessary 1:
- Creatinine clearance 25-50 mL/min: 500 mg every 12 hours 1
- Creatinine clearance 10-25 mL/min: 500 mg every 24 hours 1
- Creatinine clearance 0-10 mL/min: 500 mg every 36 hours 1

Cefadroxil can be administered without regard to meals 1
Administration with food may help reduce potential gastrointestinal complaints 1
For oral suspension, after reconstitution, store in refrigerator, shake well before using, and discard unused portion after 14 days 1

Using cephalosporins in patients with immediate (anaphylactic-type) hypersensitivity to penicillin, as up to 10% of penicillin-allergic persons are also allergic to cephalosporins 3
Using broad-spectrum antibiotics as first-line therapy when narrow-spectrum options are effective, as this increases the risk of selecting for antibiotic-resistant flora 3
Prescribing antibiotics for likely viral pharyngitis, which represents the majority of sore throat cases 2, 5
Failing to complete the full 10-day course of treatment, which is essential for preventing complications like acute rheumatic fever 2