Indication

Pneumonia, Pharyngitis, Susceptible infections, Otitis media, Skin and Skin-Structure Infections, Rheumatic fever, Tonsillitis, Respiratory tract infections, Urinary tract infections, Surgical Prophylaxis, Genitourinary tract infections, Acute prostatitis

Administration

May be taken with or without food. May be taken w/ meals to reduce GI discomfort. Parenteral doses by deep IM or slow IV inj over 3-5 min or by IV infusion. Reconstitution: IM: Add 2 mL or 4 mL of sterile water for inj or NaCl 0.9% inj to 500 mg or 1 g vial, respectively. IV: Add 5 mL of sterile water for inj, dextrose 5% inj, NaCl 0.9% inj or other suitable soln to 500 mg vial. Shake well the entire soln.

Adult dose

Adult: PO Susceptible infections 1-2 g/day in 2-4 divided doses. Max: 4 g/day. Surgical prophylaxis 1-2 g pre-op. Subsequent doses may be given as needed. Skin and skin structures and respiratory tract infection: Usual dose is 250 mg every 6 hours or 500 mg every 12 hours. Lobar pneumonia: 500 mg every 6 hours or 1 gm every 12 hours. Urinary tract infection: Usual dose is 500 mg every 12 hours. Gastro-intestinal tract infection: 500 mg three to four times daily. IV/IM Severe infections 2-4 g/day in 4 divided doses. Max: 8 g/day.

Child dose

Children: Oral: The usual total dose is 25 to 50 mg/kg/day given in 2 to 4 equally divided doses. Injection: 50 to 100 mg/kg/day in 4 equally divided doses. The usual total dose may be increased up to 200-300 mg/kg/day. Perioperative prophylaxis: Recommended dose is 1-2 gm by intramuscular or intravenous route; subsequent parenteral or oral doses are given as appropriate.

Renal dose

Renal impairment: For patients undergoing chronic intermittent haemodialysis: 250 mg may be given at the start of the session, repeated after 6-12 hr, then again 36-48 hr after the initial dose, and again at the start of the next haemodialysis if >30 hr have elapsed since the previous dose. CrCl (ml/min) >20 500 mg every 6 hr. 5-20 250 mg every 6 hr. <5 250 mg every 12 hr.

Contraindication

Hypersensitivity to cefradine or other cephalosporins; porphyria.

Mode of action

Cefradine is a 1st generation cephalosporin which inhibits the final transpeptidation step of the peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs), thus arresting cell wall synthesis leading to bacterial cell death.

Precaution

Renal impairment; history of penicillin sensitivity; pregnancy; lactation.

Side effect

Diarrhoea, nausea, vomiting; leukopenia, neutropenia, eosinophilia, rash, pruritus; joint pain; increased BUN and creatine; dizziness. Potentially Fatal: Pseudomembranous colitis.

Interaction

Increased risk of nephrotoxicity w/ loop diuretics. Decreased renal clearance w/ probenecid.