What is the recommended dose of Cefadroxil (Cefadroxil) for children?

Cefadroxil Dosing for Children

The recommended dose of cefadroxil for children is 30 mg/kg/day divided every 12 hours for urinary tract infections, pharyngitis, tonsillitis, and impetigo, or 30 mg/kg/day divided every 12 hours for other skin and skin structure infections, with a maximum daily dose of 1 gram for most indications. 1

Standard Pediatric Dosing by Indication

Urinary Tract Infections

• 30 mg/kg/day divided every 12 hours is the FDA-approved dosing for pediatric urinary tract infections 1
• This dosing should be continued for the full course of therapy, as shorter courses (1-4 days) have been shown to result in significantly higher recurrence rates (48%) compared to the standard 10-day regimen (34%) 2

Pharyngitis, Tonsillitis, and Impetigo

• 30 mg/kg/day administered either as a single daily dose or divided every 12 hours 1
• For beta-hemolytic streptococcal infections, treatment must continue for at least 10 days to prevent rheumatic fever 1

Other Skin and Skin Structure Infections

• 30 mg/kg/day divided every 12 hours 1
• Clinical studies demonstrate excellent efficacy with once-daily dosing (30 mg/kg) achieving 96% bacteriologic eradication and 94% clinical response rates for pyodermas 3

Practical Dosing Chart

The FDA label provides weight-based dosing using the available suspension formulations 1:

• 10 lbs (4.5 kg): ½ teaspoon of 250 mg/5 mL suspension
• 20 lbs (9.1 kg): 1 teaspoon of 250 mg/5 mL suspension
• 30 lbs (13.6 kg): 1½ teaspoons of 250 mg/5 mL suspension
• 40 lbs (18.2 kg): 2 teaspoons of 250 mg/5 mL OR 1 teaspoon of 500 mg/5 mL suspension
• 50 lbs (22.7 kg): 2½ teaspoons of 250 mg/5 mL OR 1¼ teaspoons of 500 mg/5 mL suspension
• 60 lbs (27.3 kg): 3 teaspoons of 250 mg/5 mL OR 1½ teaspoons of 500 mg/5 mL suspension
• 70 lbs and above (31.8+ kg): 2 teaspoons of 500 mg/5 mL suspension

Clinical Considerations

Dosing Flexibility

• Cefadroxil can be administered without regard to meals, though giving it with food may reduce gastrointestinal side effects 1
• Once-daily dosing is particularly advantageous for compliance, with studies showing 95% of patients complete 100% of once-daily medication versus only 65% with twice-daily regimens 3

Duration of Therapy

• Streptococcal infections: Minimum 10 days required 1
• Urinary tract infections: 10 days is superior to shorter courses 2
• Skin infections: Typically 10 days based on clinical response 1, 3

Renal Impairment

• While the FDA label provides adult renal dosing adjustments, pediatric patients with renal impairment require individualized dosing based on creatinine clearance, though specific pediatric guidelines are not provided in the label 1

Important Caveats

• The maximum daily dose across all indications is effectively 1 gram for most children, as demonstrated in the dosing chart 1
• Clinical studies support doses ranging from 27-56 mg/kg/day, with 40 mg/kg/day in 3-4 divided doses showing excellent efficacy 4
• Cefadroxil demonstrates longer serum half-life (1.04-1.62 hours) compared to cephalexin, supporting less frequent dosing 4
• The drug achieves excellent urinary recovery (75-96% within 6 hours) and good tissue distribution, making it particularly effective for urinary and skin infections 5, 4