Cefadroxil: Approved Indications and Clinical Uses
Cefadroxil is FDA-approved for treating urinary tract infections, skin and skin structure infections, and pharyngitis/tonsillitis caused by susceptible organisms. 1
FDA-Approved Indications
Urinary Tract Infections
- Effective against E. coli, Proteus mirabilis, and Klebsiella species 1
Skin and Skin Structure Infections
- Indicated for infections caused by staphylococci and/or streptococci 1
- Clinical studies demonstrate 88-97% cure rates for uncomplicated skin infections including abscesses, carbuncles, cellulitis, furunculosis, and impetigo 2, 3
- Effective against both methicillin-sensitive Staphylococcus aureus (MSSA) and beta-hemolytic streptococci 3, 4
Pharyngitis and Tonsillitis
- Approved for Streptococcus pyogenes (Group A beta-hemolytic streptococci) infections 1
- Cefadroxil is recommended as a narrow-spectrum cephalosporin option for penicillin-allergic patients with Group A streptococcal pharyngitis 5
- The standard dosing is 30 mg/kg once daily (maximum 1 gram) for 10 days 5
Guideline-Supported Uses
Skin and Soft Tissue Infections
- The 2014 IDSA guidelines list cefalexin (a closely related first-generation cephalosporin) for impetigo and non-purulent skin infections, and cefadroxil functions similarly as a narrow-spectrum alternative 5
- Preferred over broad-spectrum cephalosporins (cefaclor, cefuroxime, cefixime) to minimize selection of antibiotic-resistant flora 5
Diabetic Foot Infections
- Listed as an option for mild diabetic foot infections when oral therapy is appropriate 5
- Should target gram-positive organisms including S. aureus and streptococci in mild infections 5
Clinical Efficacy Data
Skin Infections
- Achieved 91-97% clinical cure rates in comparative trials against other cephalosporins 2, 4
- Bacterial eradication rates of 89-96% for S. aureus and streptococcal infections 2, 4
- Effective in pediatric populations with similar efficacy to linezolid for uncomplicated skin infections 2
Respiratory Tract Infections
- Demonstrated 93-100% clinical success rates in upper respiratory tract infections caused by S. aureus, beta-hemolytic streptococci, S. pneumoniae, and K. pneumoniae 6
- Overall bacterial eradication of 91% across 123 organisms 6
Important Caveats
Cefadroxil should not be used in patients with immediate (anaphylactic-type) hypersensitivity to penicillin, as up to 10% of penicillin-allergic patients are also allergic to cephalosporins 5
- Culture and susceptibility testing should be initiated prior to and during therapy 1
- Not proven effective for rheumatic fever prophylaxis despite effectiveness in eradicating streptococci from the oropharynx 1
- Requires twice-daily dosing (lower frequency than many oral cephalosporins that require four-times-daily administration) 3
- Well-tolerated with gastrointestinal complaints being the most common adverse events (3.7% incidence) 6