Cefracef

• Respiratory Tract Infections:
  Effective in treating pharyngitis, tonsillitis, bronchitis, and pneumonia caused by susceptible Gram-positive and Gram-negative bacteria.
• Skin and Soft Tissue Infections:
  Indicated for cellulitis, impetigo, abscesses, and wound infections.
• Urinary Tract Infections:
  Treatment of cystitis, pyelonephritis, and other urinary tract infections caused by susceptible organisms.
• Bone and Joint Infections:
  Used in osteomyelitis and septic arthritis caused by sensitive pathogens.
• Septicemia:
  As part of systemic therapy for bacteremia caused by susceptible bacteria.
• Surgical Prophylaxis:
  Prevention of postoperative infections in certain surgical procedures.

Adults:

• Typical Dose: 250 mg to 500 mg orally every 6 hours.
• Severe Infections: Up to 1 g every 6 hours.

Pediatrics:

• Dose: 25 to 50 mg/kg/day divided every 6 hours.
• Maximum Dose: Generally 4 g/day.

Renal Impairment:

• Dose adjustments required based on creatinine clearance.
• In severe impairment, dosing interval may be extended.

Administration:

• Oral capsules, tablets, or suspension.
• May be administered with or without food.

Cephradine is a first-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis. It binds to specific penicillin-binding proteins (PBPs) inside the bacterial cell wall, blocking the cross-linking of peptidoglycan chains necessary for cell wall structural integrity. This inhibition weakens the cell wall, leading to bacterial lysis and death. Cephradine is bactericidal and primarily effective against Gram-positive cocci and some Gram-negative bacilli.

• Absorption:
  Well absorbed orally, with bioavailability approximately 90%.
• Peak Plasma Concentrations:
  Achieved within 1 to 2 hours post-dose.
• Distribution:
  Widely distributed to most body tissues and fluids except cerebrospinal fluid unless meninges are inflamed.
• Protein Binding:
  Approximately 10-20%.
• Metabolism:
  Minimal hepatic metabolism.
• Elimination:
  Primarily excreted unchanged by the kidneys via glomerular filtration and tubular secretion.
• Half-life:
  Approximately 0.5 to 1 hour in normal renal function.

• Pregnancy:
  FDA Pregnancy Category B — Animal studies show no harm to fetus; limited human data available. Use only if clearly needed.
• Lactation:
  Excreted in small amounts in breast milk; considered compatible with breastfeeding.

• Antibiotic
• First-generation cephalosporin

• Known hypersensitivity to cephradine or other cephalosporins.
• History of severe allergic reactions to penicillins or β-lactams.

• Monitor for allergic reactions including anaphylaxis.
• Use caution in patients with a history of gastrointestinal disease, particularly colitis.
• Adjust dose in patients with renal impairment.
• Prolonged use may result in superinfection including fungal infections.
• Discontinue if severe diarrhea or signs of Clostridioides difficile infection occur.

Common:

• Gastrointestinal: Diarrhea, nausea, vomiting, abdominal discomfort.
• Dermatologic: Rash, itching.
• Others: Headache, dizziness.

Rare/Serious:

• Anaphylaxis.
• Stevens-Johnson syndrome.
• Hematologic: Neutropenia, thrombocytopenia.

• Probenecid: May increase plasma concentration by reducing renal tubular secretion.
• Oral Contraceptives: Potential reduced efficacy; recommend alternative contraception.
• No significant CYP450 interactions.
• Caution when combined with nephrotoxic agents.

• No major recent changes in indication or dosing.
• Continues to be recommended for treatment of susceptible infections and surgical prophylaxis.
• Emphasis on antibiotic stewardship to reduce resistance development.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep container tightly closed.
• Avoid freezing.
• Keep out of reach of children.