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# Forcef (cephradine)
## Overview
Cephradine is a first-generation cephalosporin antibiotic. It is bactericidal and works by inhibiting bacterial cell wall synthesis.
## Primary Indications
* Skin and skin structure infections (e.g., cellulitis, impetigo)
* Respiratory tract infections (e.g., pneumonia, bronchitis)
* Urinary tract infections (e.g., cystitis, pyelonephritis)
* Bone and joint infections
## Adult Dosing
* **Respiratory tract infections and skin/skin structure infections:** 250 mg to 500 mg orally every 6 hours.
* **Urinary tract infections:** 250 mg to 500 mg orally every 6 hours, or 500 mg to 1 g orally every 12 hours.
* **Severe infections:** May require higher doses, up to 1 g every 6 hours.
## Pediatric Dosing
* **General pediatric use:** 25 mg to 50 mg per kg per day orally, divided into four equally divided doses.
* **Severe infections:** May require doses up to 75 mg to 100 mg per kg per day.
* Maximum adult dose should not be exceeded.
## Dose Adjustments
* **Renal impairment:** Dosage adjustments are necessary based on creatinine clearance. Consult specific guidelines for exact recommendations. Generally, doses should be reduced or dosing interval extended.
## Contraindications
* Known hypersensitivity to cephradine or other cephalosporins.
* Known hypersensitivity to penicillin (cross-reactivity is possible, though less common with first-generation cephalosporins).
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, rash, urticaria.
* **Serious:** Anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, Clostridioides difficile-associated diarrhea, neutropenia, eosinophilia.
## Key Drug Interactions
* **Probenecid:** May increase and prolong cephradine serum levels.
* **Oral contraceptives:** Cephalosporins may reduce the efficacy of oral contraceptives. Advise patients to use alternative non-hormonal contraception.
## Monitoring
* Monitor for signs and symptoms of allergic reaction.
* Monitor for gastrointestinal side effects, especially C. difficile-associated diarrhea.
* Renal function in patients with impaired renal function.
* Consider therapeutic drug monitoring for severe infections or suspected toxicity if local protocols recommend.
## Clinical Pearls
* Cephradine can be taken with or without food.
* Ensure adequate hydration during treatment.
* Complete the full course of therapy as prescribed, even if symptoms improve.
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**Disclaimer:** This information is intended as a quick reference and does not replace the need to consult the most current prescribing information, product monographs, or expert clinical judgment. Always verify dosage and safety information with the latest official sources before initiating therapy.
