Cephradine

Cephradine is a semisynthetic broad spectrum bactericidal antibiotic, active against infections caused by both gram-positive and gram-negative microorganisms. Both penicillinase producing and nonproducing staphylococci are sensitive to Cephradine. The main site of action of Cephradine is the cell wall of bacteria. Cell wall of sensitive organism contains peptidoglycan. Cephradine inhibits cross-linking process and as a result cell wall with many pores are formed, thus lysis of bacteria occur due to external osmotic pressure. Cephradine may be taken with or without food. May be taken with meals to reduce GI discomfort. Parenteral doses by deep IM or slow IV inj over 3-5 min or by IV infusion.

• Upper Respiratory Tract Infections (sinusitis, pharyngitis, tonsillitis, otitis media)
• Lower Respiratory Tract Infections (bronchitis, lobar pneumonia)
• Urinary Tract Infections (cystitis, urethritis, pyelonephritis)
• Skin and Soft Tissue Infections (abscess, cellulitis, furunculosis, impetigo)
• Surgical Prophylaxis
• Genitourinary Tract Infections
• Acute Prostatitis

Cephradine is a semisynthetic broad spectrum bactericidal antibiotic, it is active against infections caused by both gram-positive and gram-negative microorganisms. Both penicillinase producing and nonproducing staphylococci are sensitive to Cephradine. The main site of action of Cephradine is the cell wall of bacteria. Cell wall of sensitive organism contains peptidoglycan. Cephradine inhibits cross-linking process and as a result cell wall with many pores are formed, thus lysis of bacteria occur due to external osmotic pressure.

Cephradine 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.

Adult Dose (Oral):

Adult Dose (Parenteral): Severe infections 2-4 g/day (4 divided doses), Max 8 g/day.

Surgical Prophylaxis: 1-2 g pre-op (IM/IV).

Pediatric Dose (Oral): 25-50 mg/kg/day (2-4 divided doses); Otitis media: 75-100 mg/kg/day (6-12 hourly).

Pediatric Dose (Injection): 50-100 mg/kg/day (4 divided doses); severe infections up to 200-300 mg/kg/day.

Renal Dose:

May be taken with or without food. May be taken with 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 or NaCl 0.9% to 500 mg or 1 g vial respectively.

Reconstitution (IV): Add 5 mL of sterile water, dextrose 5%, NaCl 0.9% or other suitable solution to 500 mg vial. Shake well.

If you miss a dose of Cephradine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Diarrhea
• Nausea
• Vomiting
• Leukopenia
• Neutropenia
• Eosinophilia
• Rash
• Pruritus
• Joint pain
• Increased BUN and creatinine
• Dizziness

Rare: Glossitis, heartburn, chest tightness, abdominal pain, vaginitis, candida overgrowth, blood disorders, hepatic enzyme elevation, interstitial nephritis.

Potentially Fatal: Pseudomembranous colitis.

• Use with caution in renal impairment; dose adjustment needed.
• History of penicillin sensitivity; caution due to cross-sensitivity risk.
• Prolonged use may result in superinfection due to resistant organisms.
• Caution during pregnancy and lactation.
• Cephalosporins may cause false positive Coombs' test.
• May cause false positive urine glucose with Benedict's or Fehling's solutions or Clinitest tablets.
• Contains lactose; not recommended for patients with galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption.

• Hypersensitivity to cephradine or other cephalosporins.
• Porphyria.

Increased risk of nephrotoxicity with loop diuretics. Decreased renal clearance with probenecid. Concomitant use with aminoglycosides may increase risk of kidney damage.

Information on alcohol consumption with Cephradine is not available. It is advised to avoid alcohol.

Safety in pregnancy has not been established. Animal studies have not demonstrated teratogenicity. Should be used during pregnancy only if clearly needed. Pregnancy Category B.

Cephradine is excreted in breast milk. Should be used with caution in lactating mothers.

Pediatric dose: Oral 25-50 mg/kg/day (2-4 divided doses); Otitis media: 75-100 mg/kg/day (6-12 hourly); Injection: 50-100 mg/kg/day (4 divided doses), severe infections up to 200-300 mg/kg/day.

The normal adult dose is appropriate for elderly patients. Patients with impaired renal or hepatic function should be monitored during treatment.

[CAUTION] Cephradine should be used with caution in patients with kidney disease. Dose adjustment of Cephradine may be needed. Please consult your doctor.

For hemodialysis patients: 250 mg at start of session, repeated after 6-12 hours, then 36-48 hours after initial dose, and at start of next dialysis if >30 hours have elapsed.

Overdose symptoms are generally nausea, vomiting, diarrhea and gastric upsets. Treatment is mainly supportive although gastric lavage will be necessary if a large amount has been ingested.

Cephradine Suspension should be freshly prepared. Reconstituted suspension should be used within 7 days at room temperature or within 14 days if refrigerated. Injection solutions should be used within 2 hours at room temperature or within 12 hours at 5°C. Do not use later than the date of expiry. Keep out of reach of children.

Cephradine