Cefadroxil is a first-generation cephalosporin antibiotic indicated for the treatment of a wide range of bacterial infections. It exerts its bactericidal effect by inhibiting bacterial cell wall synthesis, leading to osmotic instability and cell lysis. With excellent oral bioavailability and a broad spectrum of activity against Gram-positive organisms and some Gram-negative bacteria, cefadroxil remains a clinically relevant option in outpatient and community settings. Its once or twice-daily dosing regimen supports patient adherence and simplifies treatment protocols.

Features

• Belongs to the first-generation cephalosporin class
• Available in oral formulations: capsules (500 mg) and powder for suspension (250 mg/5 mL, 500 mg/5 mL)
• Bactericidal mechanism: inhibits transpeptidation step in peptidoglycan synthesis
• Acid-stable, allowing for consistent absorption regardless of gastric pH
• Spectrum includes Staphylococcus aureus (non-MRSA), Streptococcus pyogenes, E. coli, Proteus mirabilis, and Klebsiella pneumoniae

Benefits

• Effective against common skin, soft tissue, and urinary tract pathogens
• Convenient once or twice-daily dosing improves compliance
• Well-tolerated profile with low incidence of severe adverse effects
• Suitable for pediatric and adult populations with weight-based dosing
• Lower risk of Clostridioides difficile infection compared to broader-spectrum antibiotics
• Cost-effective generic availability supports accessibility

Common use

Cefadroxil is primarily prescribed for uncomplicated skin and skin structure infections, such as impetigo, cellulitis, and wound infections caused by susceptible Staphylococcus and Streptococcus species. It is also indicated for pharyngitis and tonsillitis due to Group A beta-hemolytic streptococci, offering an alternative for penicillin-allergic patients (non-anaphylactic allergy). Additionally, it is used for urinary tract infections caused by E. coli, Proteus mirabilis, and Klebsiella species. Off-label uses may include prophylaxis in minor surgical procedures or dental work in at-risk individuals.

Dosage and direction

Adults:

• Skin and soft tissue infections: 500 mg to 1 g orally every 12 hours
• Pharyngitis/tonsillitis: 1 g once daily or 500 mg every 12 hours for 10 days
• Urinary tract infections: 1 to 2 g once daily or in divided doses

Pediatric dosing:

• Based on 30 mg/kg/day in divided doses every 12 hours; for pharyngitis, 30 mg/kg once daily
• Maximum dose should not exceed adult dosing

Administration with or without food is acceptable, though taking with food may minimize gastrointestinal upset. Complete the full course of therapy even if symptoms resolve earlier to prevent resistance.

Precautions

Use with caution in patients with renal impairment; dosage adjustment is required based on creatinine clearance. Monitor for superinfection or fungal overgrowth, especially with prolonged use. Not recommended for the treatment of meningitis due to poor cerebrospinal fluid penetration. Use in pregnancy (Category B) should be reserved for cases where potential benefit justifies potential risk. Exercise caution in breastfeeding—cefadroxil is excreted in human milk. Perform culture and susceptibility testing to confirm organism sensitivity when feasible.

Contraindications

Hypersensitivity to cefadroxil, any cephalosporin, or any component of the formulation. Cross-sensitivity with penicillins may occur; avoid in patients with a history of anaphylactic reaction to penicillins. Do not use for viral infections such as the common cold or influenza.

Possible side effect

Common adverse reactions (≥1%) include diarrhea, nausea, vomiting, abdominal discomfort, and vaginitis. Less frequently, rash, urticaria, pruritus, dizziness, and fatigue may occur. Rare but serious effects include pseudomembranous colitis, Stevens-Johnson syndrome, hemolytic anemia, neutropenia, and elevated liver enzymes. Discontinue and seek medical attention if severe diarrhea, bloody stools, or signs of hypersensitivity develop.

Drug interaction

Probenecid may reduce renal excretion of cefadroxil, increasing serum levels. Concurrent use with nephrotoxic drugs (e.g., aminoglycosides, loop diuretics) may enhance renal toxicity. Antacids containing magnesium or aluminum may reduce absorption—separate administration by at least 2 hours. Oral anticoagulants: monitor INR, as cephalosporins may potentiate warfarin effect.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to catch up. Maintain the regular dosing schedule to ensure consistent therapeutic levels.

Overdose

Symptoms may include nausea, vomiting, epigastric distress, diarrhea, and hematuria. Management is supportive; gastric lavage may be considered if ingestion was recent. Hemodialysis can remove cefadroxil from the bloodstream. There is no specific antidote.

Storage

Store at controlled room temperature (20–25°C). Keep container tightly closed. Protect from light and moisture. Reconstituted suspension is stable for 14 days at room temperature or under refrigeration; discard any unused portion after this period. Keep out of reach of children.

Disclaimer

This information is for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a healthcare provider for personalized recommendations. Do not initiate, adjust, or discontinue medication without physician guidance.

Reviews

“Cefadroxil has been a reliable choice in my practice for uncomplicated skin infections. The once-daily option is particularly useful for adherence in younger and older populations.” – Dr. Elena Morris, Infectious Disease Specialist
“Effective for strep pharyngitis in penicillin-allergic patients. I appreciate the low cost and generally mild side effect profile.” – Dr. Robert T. Lin, Family Medicine
“Used cefadroxil for a recurrent UTI—symptoms improved within two days. Finished the course with no GI issues.” – Patient, verified user
“Pediatric suspension is palatable, which is a plus. My child completed the full course without resistance.” – Parent reviewer