From the Guidelines
Cefadroxil is a suitable treatment option for MSSA UTI, with a recommended dosage of 500 mg orally twice daily for 3 days, provided the local resistance pattern for Escherichia coli is <20%. The European Association of Urology guidelines suggest cefadroxil as an alternative treatment for uncomplicated cystitis, with a specified duration of 3 days 1. This recommendation is based on the guidelines' suggested antimicrobial therapy regimens for uncomplicated cystitis, which include cefadroxil as a cephalosporin option. Key points to consider when treating MSSA UTI with cefadroxil include:
- Local resistance patterns: Cefadroxil should only be used if the local resistance pattern for Escherichia coli is <20% 1.
- Dosage and duration: The recommended dosage is 500 mg orally twice daily for 3 days 1.
- Patient monitoring: Patients should be monitored for symptoms and side effects, and alternative antibiotics may be needed if symptoms worsen or do not improve within 48-72 hours.
- Common side effects: Gastrointestinal disturbances like diarrhea and nausea are common side effects, and patients with penicillin allergies should use cefadroxil cautiously due to potential cross-reactivity. It is essential to note that cefadroxil achieves good urinary concentrations, making it suitable for UTI treatment, and patients should complete the full course of antibiotics even if symptoms improve before completion 1.
From the Research
Treatment of MSSA UTI with Cefadroxil
- Cefadroxil is an oral first-generation cephalosporin that can be used to treat methicillin-susceptible Staphylococcus aureus (MSSA) infections 2.
- The minimum inhibitory concentrations (MICs) of cefadroxil and cephalexin against MSSA isolates are similar, suggesting that cefadroxil can be an alternative to cephalexin for the treatment of MSSA infections 2.
- However, the use of cefadroxil for the treatment of urinary tract infections (UTIs) caused by MSSA is not well-established, and more research is needed to determine its effectiveness in this setting.
Treatment Options for UTIs
- The recommended first-line empiric antibiotic therapy for acute uncomplicated bacterial cystitis in otherwise healthy adult nonpregnant females includes nitrofurantoin, fosfomycin tromethamine, or pivmecillinam 3.
- Second-line options for UTIs include oral cephalosporins such as cephalexin or cefixime, fluoroquinolones, and β-lactams such as amoxicillin-clavulanate 3.
- Cefadroxil is not listed as a recommended treatment option for UTIs in the provided studies, but it may be considered as an alternative to cephalexin in certain cases 2.
Pharmacological Properties of Oral Antibiotics
- The choice of oral antibiotic for the treatment of uncomplicated UTIs should be based on the pharmacokinetic characteristics of the molecule to optimize clinical benefit and minimize the risk of antibacterial resistance 4.
- Cefadroxil has a slower clearance and possibility for less frequent dosing compared to cephalexin, which may make it an appealing alternative for the treatment of certain infections 2.