Cefadroxil Dosing and Treatment Duration for Bacterial Infections
For group A streptococcal pharyngitis, administer cefadroxil 30 mg/kg once daily (maximum 1 gram) for 10 days, and for skin/soft tissue infections, use 30 mg/kg/day divided every 12 hours for 7-10 days. 1, 2
Group A Streptococcal Pharyngitis
- Cefadroxil is a first-line alternative to penicillin for streptococcal pharyngitis with strong, high-quality evidence supporting its use 1
- Dosing: 30 mg/kg once daily (maximum 1 gram) for 10 days 1
- The 10-day duration is critical to prevent rheumatic fever and other suppurative complications 1, 3
- Avoid cefadroxil in patients with immediate-type hypersensitivity to penicillin 1
Urinary Tract Infections
Adults
- Uncomplicated lower UTI (cystitis): 1-2 grams per day as a single dose or divided twice daily 2
- All other UTIs: 2 grams per day in divided doses (twice daily) 2
- Treatment duration: 7-10 days for uncomplicated infections 2, 4
- Urinary recovery rate reaches 75-96% within 6 hours of administration 5
Children
- 30 mg/kg/day divided every 12 hours 2
- Clinical studies demonstrate 100% efficacy in pediatric UTIs at this dosing 5
Skin and Skin Structure Infections
Adults
- 1 gram per day as a single dose or divided twice daily 2
- Duration: 7-10 days depending on clinical response 3, 2
- Clinical improvement should be evident within 48-72 hours 3
Children
- 30 mg/kg/day in equally divided doses every 12 hours 2
- For impetigo specifically: 30 mg/kg/day as a single dose or divided every 12 hours 2
- Treatment duration: 7-10 days 2, 6
Renal Impairment Adjustments
Dosage must be adjusted based on creatinine clearance to prevent drug accumulation 2:
- Initial dose: 1000 mg in all patients 2
- Maintenance dosing (500 mg at intervals based on CrCl):
Pharmacokinetic Advantages
- Cefadroxil has a longer serum half-life (1.04-1.62 hours) compared to cephalexin, allowing once or twice-daily dosing 7, 5
- Food intake does not affect absorption, permitting administration with meals to reduce gastrointestinal side effects 2, 7
- Peak serum concentrations occur at 1-2 hours post-dose, reaching 13.4-17.1 mcg/mL after 10-14.3 mg/kg doses 5
Administration Guidelines
- May be administered without regard to meals; giving with food may reduce GI complaints 2
- Oral suspension: Shake well before each use and refrigerate after reconstitution 2
- Discard unused suspension after 14 days 2
Clinical Efficacy Data
- Twice-daily cefadroxil (1000 mg) demonstrates equivalent efficacy to cephalexin 500 mg four times daily for UTIs 4
- Satisfactory clinical outcomes achieved in 94% of skin/soft tissue infections 8
- 100% efficacy rate in pediatric scarlet fever when dosed at 30-49 mg/kg/day 6
- Beta-hemolytic Streptococcus eradication occurs within 1-2 days in most cases 6
Safety Profile
- Well-tolerated with minimal adverse effects 5, 4, 8
- Most common side effects: mild gastrointestinal symptoms (diarrhea, vomiting) 5, 6
- Rare transient elevation of liver enzymes (GOT/GPT) 5, 6
- No significant drug-related adverse events requiring discontinuation in clinical trials 4, 8