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Uses

Pharyngitis and Tonsillitis

Treatment of pharyngitis and tonsillitis caused by Streptococcus pyogenes (group A β-hemolytic streptococci). Generally effective in eradicating S. pyogenes from the nasopharynx, but efficacy in prevention of subsequent rheumatic fever has not been established to date.

CDC, AAP, IDSA, AHA, and others recommend oral penicillin V or IM penicillin G benzathine as treatments of choice; oral cephalosporins and oral macrolides considered alternatives. Amoxicillin sometimes used instead of penicillin V, especially for young children.

Skin and Skin Structure Infections

Treatment of mild to moderate skin and skin structure infections caused by susceptible staphylococci or streptococci.

Urinary Tract Infections (UTIs)

Treatment of mild to moderate UTIs, include acute prostatitis, caused by susceptible Escherichia coli, Klebsiella, or Proteus mirabilis.

Prevention of Bacterial Endocarditis

Alternative for prevention of α-hemolytic (viridans group) streptococcal endocarditis† in penicillin-allergic individuals undergoing certain dental or upper respiratory tract procedures who have cardiac conditions that put them at highest risk. Should not be used in those with immediate-type penicillin hypersensitivity (see Cross-hypersensitivity under Cautions).

When selecting anti-infectives for prophylaxis of bacterial endocarditis, consult most recent AHA recommendations for specific information on which cardiac conditions are associated with highest risk of endocarditis and which procedures require prophylaxis.

Dosage and Administration

Administration

Oral Administration

Administer orally.

May be given without regard to meals; administration with food may minimize adverse GI effects.

Dosage

Available as the monohydrate; dosage expressed as cefadroxil.

Pediatric Patients

General Pediatric Dosage

Oral

AAP recommends 30 mg/kg daily in 2 equally divided doses for treatment of mild or moderately severe infections in children ≥1 month of age. AAP states the drug is inappropriate for treatment of severe infections.

Pharyngitis and Tonsillitis

Oral

30 mg/kg daily given as a single dose or in 2 equally divided doses for ≥10 days.

Skin and Skin Structure Infections

Impetigo

Oral

30 mg/kg daily given as a single dose or in 2 equally divided doses.

Other Skin and Skin Structure Infections

Oral

30 mg/kg daily given in 2 equally divided doses.

Urinary Tract Infections (UTIs)

Oral

30 mg/kg daily given in 2 equally divided doses.

Prevention of Bacterial Endocarditis

Patients Undergoing Certain Dental or Upper Respiratory Tract Procedures

Oral

50 mg/kg (up to 2 g) as a single dose given 1 hour prior to the procedure.†

Adults

Pharyngitis and Tonsillitis

Oral

1 g daily given as a single dose or in 2 divided doses for 10 days.

Skin and Skin Structure Infections

Oral

1 g daily given as a single dose or in 2 divided doses.

Urinary Tract Infections (UTIs)

Uncomplicated Lower UTIs (e.g., Cystitis)

Oral

1 or 2 g daily given as a single dose or in 2 divided doses.

Other UTIs

Oral

2 g daily given in 2 divided doses.

Prevention of Bacterial Endocarditis

Patients Undergoing Certain Dental or Upper Respiratory Tract Procedures

Oral

2 g as a single dose given 1 hour prior to the procedure.†

Special Populations

Renal Impairment

Dosage adjustments required if Cl_cr ≤50 mL/minute per 1.73 m². Use an initial 1-g induction dose followed by 500-mg maintenance doses given at intervals based on the degree of renal impairment. (See Table.)

Geriatric Patients

No dosage adjustments except those related to renal impairment. Cautious dosage selection because of age-related decreases in renal function. (See Renal Impairment under Dosage and Administration.)