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# Forcef (Cephradine)
## Overview
Cephradine is a first-generation cephalosporin antibiotic.
## Primary Indications
* Skin and skin structure infections
* Respiratory tract infections
* Urinary tract infections
* Bone and joint infections
* Septicemia
Caused by susceptible strains of microorganisms.
## Adult Dosing
* **General Infections:** 250 mg to 500 mg orally every 6 hours, or 500 mg to 1 g intravenously or intramuscularly every 6 to 12 hours.
* **Severe Infections:** Doses may be increased up to 1 g every 6 hours orally or 2 g every 6 to 12 hours intravenously or intramuscularly.
* **Maximum Oral Dose:** 4 g daily.
* **Maximum IV/IM Dose:** 8 g daily.
## Pediatric Dosing
* **Oral:** 25 mg to 50 mg/kg/day in equally divided doses every 6 hours.
* For more severe infections or infections caused by less susceptible organisms: 50 mg to 100 mg/kg/day in equally divided doses every 6 hours.
* **IV/IM:** 25 mg to 50 mg/kg/day in equally divided doses every 6 to 12 hours.
* For more severe infections: 50 mg to 100 mg/kg/day in equally divided doses every 6 hours.
* Doses should not exceed the adult maximum.
## Dose Adjustments
* **Renal Impairment:** Dosage reduction is necessary for patients with significantly impaired renal function. Specific guidelines depend on the calculated creatinine clearance. Consult institutional dosing guidelines.
## Contraindications
* Known hypersensitivity to cephradine or other cephalosporins.
* History of severe immediate hypersensitivity reaction to penicillin.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, rash, eosinophilia.
* **Less Common:** Abdominal pain, dyspepsia, headache, dizziness, vaginal candidiasis, Stevens-Johnson syndrome, toxic epidermal necrolysis.
* **Serious:** Anaphylaxis, Clostridioides difficile-associated diarrhea.
## Key Drug Interactions
* **Probenecid:** May increase cephradine serum concentrations.
* **Aminoglycosides:** Potential for additive nephrotoxicity.
* **Oral Contraceptives:** Effectiveness may be reduced.
## Monitoring
* Renal function (especially in patients with pre-existing renal disease or receiving other nephrotoxic agents).
* Liver function.
* Signs and symptoms of hypersensitivity reactions.
* Signs and symptoms of C. difficile infection.
## Clinical Pearls
* Administer oral formulations with or without food.
* Intravenous preparations are typically administered over 30-60 minutes.
* Intramuscular injections may cause pain at the injection site.
* Consider direct Coombs' test may be positive.
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**Disclaimer:** This information is intended for clinical use and does not replace comprehensive drug information resources. Always consult the most current prescribing information and institutional protocols before administering any medication.
