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# Cephradine
## Overview
Cephradine is a first-generation cephalosporin antibiotic effective against many gram-positive and some gram-negative bacteria. It is available in oral and parenteral formulations.
## Primary Indications
* Respiratory tract infections (e.g., pneumonia, bronchitis)
* Urinary tract infections
* Skin and skin structure infections
* Bone and joint infections
* Septicemia
* Endocarditis (prophylaxis)
## Adult Dosing
* **Oral:** 250 mg to 500 mg every 6 hours.
* Severe infections may require up to 1 gram every 6 hours.
* **Parenteral:** 500 mg to 1 gram every 6 hours.
* Severe infections may require up to 2 grams every 6 hours.
## Pediatric Dosing
* **Oral:** 25 to 50 mg/kg/day divided into 4 doses.
* Severe infections may require up to 75 to 100 mg/kg/day divided into 4 doses. Do not exceed adult doses.
* **Parenteral:** 25 to 50 mg/kg/day divided into 4 doses.
* Severe infections may require up to 100 mg/kg/day divided into 4 doses. Do not exceed adult doses.
## Dose Adjustments
* **Renal Impairment:** Dose reduction is necessary. Specific guidelines depend on the calculated creatinine clearance and may require consultation with local protocols.
## Contraindications
* Hypersensitivity to cephradine or other cephalosporins.
* Hypersensitivity to penicillin (cross-reactivity may occur).
## Adverse Effects
Common: Diarrhea, nausea, vomiting, rash, pruritus.
Serious: Anaphylaxis, pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, Clostridioides difficile-associated diarrhea, interstitial nephritis.
## Key Drug Interactions
* **Probenecid:** May decrease renal excretion of cephradine, increasing serum levels.
* **Aminoglycosides:** Potential for increased nephrotoxicity.
* **Oral anticoagulants (e.g., warfarin):** Cephalosporins may affect vitamin K synthesis, potentially increasing the risk of bleeding. Monitor INR closely.
* **Hormonal contraceptives:** Reduced efficacy may occur.
## Monitoring
* Renal function (BUN, creatinine).
* Signs and symptoms of infection.
* Bowel function for signs of diarrhea or C. difficile.
* Allergic reactions.
## Clinical Pearls
* Cephradine has a broader spectrum than some other first-generation cephalosporins.
* Oral absorption is not significantly affected by food.
* The parenteral formulation can be administered intramuscularly or intravenously.
* Culture and sensitivity testing are recommended before initiating treatment to guide therapy.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines for complete details and to ensure patient safety.
