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First-generation oral cephalosporin

Cefadroxil

Brand names: Baxan (UK historical), Duricef

Cefadroxil is an oral first-generation cephalosporin antibiotic used for susceptible skin and soft-tissue, urinary tract and streptococcal throat infections.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 1 g to 2 g per day, depending on indication
Route: Oral — cefadroxil is acid-stable and may be administered without regard to meals; administration with food may help diminish gastrointestinal complaints
Frequency: As a single daily dose (q.d.) or in two divided doses (b.i.d.), depending on indication
BY INDICATION (US labelling): Uncomplicated lower urinary tract infection (i.e. cystitis) — usual dosage 1 or 2 g per day in a single dose or divided doses (b.i.d.). All other urinary tract infections — usual dosage 2 g per day in divided doses (b.i.d.). Skin and skin structure infections — usual dosage 1 g per day in a single dose or divided doses (b.i.d.). Pharyngitis and tonsillitis (group A beta-haemolytic streptococcal) — 1 g per day in a single dose or divided doses (b.i.d.) for 10 days. In the treatment of beta-haemolytic streptococcal infections a therapeutic dosage should be given for at least 10 days. SOURCE: no UK SPC was fetched in this bundle — distilled from the US prescribing information and must be verified against the UK SPC.

Paediatric dose

Dose: 30 mg/kg
Route: Oral
Frequency: 30 mg/kg/day in divided doses every 12 hours (for pharyngitis, tonsillitis and impetigo it may be given as a single daily dose or in equally divided doses every 12 hours)
Max: Not stated in the source label
US labelling, children: urinary tract infections — 30 mg/kg/day in divided doses every 12 hours; pharyngitis, tonsillitis and impetigo — 30 mg/kg/day as a single dose or in equally divided doses every 12 hours; other skin and skin structure infections — 30 mg/kg/day in equally divided doses every 12 hours. Beta-haemolytic streptococcal infections should be treated for at least 10 days. No lower age limit is given in the fetched text. This is US labelling, not a UK SPC — the clinician must verify the paediatric regimen against a children's formulary before use.

Dose adjustments

Renal

In renal impairment the dosage should be adjusted according to creatinine clearance to prevent drug accumulation. In adults the initial dose is 1000 mg and the maintenance dose is 500 mg at the following intervals: CrCl 0 to 10 mL/min — every 36 hours; 10 to 25 mL/min — every 24 hours; 25 to 50 mL/min — every 12 hours. Patients with creatinine clearance over 50 mL/min may be treated as if they had normal renal function.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Paediatric weight-based calculator

US labelling, children: urinary tract infections — 30 mg/kg/day in divided doses every 12 hours; pharyngitis, tonsillitis and impetigo — 30 mg/kg/day as a single dose or in equally divided doses every 12 hours; other skin and skin structure infections — 30 mg/kg/day in equally divided doses every 12 hours. Beta-haemolytic streptococcal infections should be treated for at least 10 days. No lower age limit is given in the fetched text. This is US labelling, not a UK SPC — the clinician must verify the paediatric regimen against a children's formulary before use.

Verify in a children's formulary

Contraindications

  • Known allergy to the cephalosporin group of antibiotics

Side effects

  • Gastrointestinal — diarrhoea; dyspepsia, nausea and vomiting reported rarely; pseudomembranous colitis may occur during or after antibiotic treatment
  • Hypersensitivity — rash, urticaria, angioedema and pruritus, usually subsiding on discontinuation; anaphylaxis has also been reported
  • Hepatic dysfunction including cholestasis and elevations in serum transaminase
  • Genital pruritus, genital moniliasis, vaginitis; moderate transient neutropenia; fever
  • Rarely — agranulocytosis, thrombocytopenia, idiosyncratic hepatic failure, erythema multiforme, Stevens-Johnson syndrome, serum sickness and arthralgia

Clinical monograph

How it works

It is bactericidal, binding penicillin-binding proteins to inhibit cross-linking of bacterial cell-wall peptidoglycan, causing cell death.

Prescribing in practice

  • Avoid in patients with a history of immediate or severe hypersensitivity to penicillins or cephalosporins because of the risk of cross-reactivity.
  • Dose interval should be extended in renal impairment as it is renally cleared (consult the SPC).
  • Like other broad-spectrum agents, it can predispose to Clostridioides difficile and candidal superinfection.

Monitoring

Routine monitoring is not required, though renal function guides dosing in impairment; review for allergy and new diarrhoea.

Counselling the patient

  • Take the full course as prescribed even if symptoms improve quickly.
  • Seek urgent help for any rash, facial swelling or difficulty breathing.
  • Report severe or bloody diarrhoea promptly.

Evidence & guidelines

Cefadroxil is a well-established oral cephalosporin whose use is supported by long clinical experience and the SPC.

Reference: SmPC Duricef; NICE CKS Sore Throat; UKHSA UTI Guidelines 2024; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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