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# Cephradine
## Overview
Cephradine is a first-generation cephalosporin antibiotic. It is bactericidal and acts by inhibiting bacterial cell wall synthesis.
## Primary Indications
* Skin and soft tissue infections
* Respiratory tract infections
* Urinary tract infections
* Bone and joint infections
* Prophylaxis for certain surgical procedures
## Adult Dosing
* **General Infections:** 250 mg to 500 mg orally every 6 hours or 500 mg to 1 g intravenously/intramuscularly every 6 to 12 hours.
* **Severe Infections:** Doses may be increased up to 4 g per day intravenously.
* **Urinary Tract Infections:** 500 mg orally every 12 hours.
## Pediatric Dosing
* **Oral:** 25 mg to 50 mg per kg per day divided into 4 doses. Maximum daily dose is 2 g to 4 g depending on indication (consult specific guidelines).
* **Intravenous/Intramuscular:** 25 mg to 75 mg per kg per day divided into 3 to 4 doses. Maximum daily dose is 16 g per day (consult specific guidelines).
## Dose Adjustments
* **Renal Impairment:** Dose reduction is necessary in patients with impaired renal function. Specific adjustments depend on the calculated creatinine clearance. Initial doses may be similar to normal renal function, followed by reduced maintenance doses and/or increased dosing intervals.
## Contraindications
* Hypersensitivity to cephradine or other cephalosporins.
* Hypersensitivity to penicillin (cross-reactivity is possible).
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, rash, pruritus.
* **Less Common:** Headache, dizziness, candidiasis, eosinophilia, neutropenia, thrombocytopenia, elevated liver enzymes.
* **Rare:** Clostridium difficile-associated diarrhea, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis, seizures (especially with high IV doses in renal impairment).
## Key Drug Interactions
* **Probenecid:** May decrease renal excretion of cephradine, increasing serum levels.
* **Aminoglycosides:** Concomitant use may increase the risk of nephrotoxicity.
* **Oral Contraceptives:** Cephradine may decrease the efficacy of oral contraceptives.
## Monitoring
* Monitor for signs of hypersensitivity reactions.
* Monitor for signs and symptoms of C. difficile-associated diarrhea.
* Renal function tests (BUN, creatinine) may be warranted, especially in patients with pre-existing renal disease or those receiving concurrent nephrotoxic agents.
* Liver function tests may be monitored periodically.
* Monitor for effectiveness of treatment (resolution of signs and symptoms of infection).
## Clinical Pearls
* Cephradine should be used cautiously in patients with a history of gastrointestinal disease, particularly colitis.
* Ensure adequate hydration during treatment, especially when administering intravenously.
* Drug-induced serum sickness-like reactions have been reported.
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**Disclaimer:** This information is intended for educational purposes only and does not constitute medical advice. Always consult the most current prescribing information and your healthcare provider for any questions regarding medication use. Dosing may vary based on individual patient factors and local institutional protocols.
