Pharmacology:
Cephradine is a first-generation cephalosporin antibiotic, structurally related to penicillins. It is bactericidal, inhibiting bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to lysis and death of susceptible bacteria. It is stable against many beta-lactamases produced by Gram-positive organisms.
Indication:
Cephradine is used to treat a variety of infections, including:
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Respiratory tract infections (e.g., pharyngitis, tonsillitis, bronchitis)
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Otitis media
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Skin and soft tissue infections
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Urinary tract infections (UTIs)
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Bone and joint infections
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Post-operative and wound infections
Dosage & Administration:
Adults:
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Upper respiratory infections, skin infections, and UTIs: 250–500 mg every 6 or 12 hours.
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Severe infections or pneumonia: 1 g every 6–12 hours.
Children:
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25–50 mg/kg/day in divided doses every 6–12 hours.
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Maximum: 100 mg/kg/day for severe infections.
Route: Oral or Intramuscular (IM) / Intravenous (IV)
Note: Adjust dose in renal impairment.
Interaction:
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Probenecid: May increase and prolong blood levels of cephradine by reducing renal excretion.
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May interfere with urine glucose tests (false positives with Benedict’s solution, Fehling’s solution).
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Nephrotoxicity risk increases when combined with aminoglycosides or loop diuretics.
Contraindications:
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Hypersensitivity to cephradine, other cephalosporins, or beta-lactam antibiotics (like penicillins).
Side Effects:
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Common: Nausea, vomiting, diarrhea, abdominal pain
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Allergic reactions: Rash, urticaria, anaphylaxis (rare)
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Hematologic: Eosinophilia, neutropenia, thrombocytopenia (rare)
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Renal: Transient elevations in BUN and creatinine
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Superinfection: Including Clostridioides difficile–associated diarrhea (CDAD)
Pregnancy & Lactation:
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Pregnancy Category B: Animal studies show no risk; no adequate studies in pregnant women. Use only if clearly needed.
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Excreted in breast milk in small amounts; caution advised during lactation.
Precautions & Warnings:
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Use cautiously in patients with renal impairment.
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Cross-sensitivity with penicillins; avoid in known penicillin allergy.
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Monitor for superinfections during prolonged use.
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Use with caution in patients with gastrointestinal disease, especially colitis.
Overdose Effects:
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May cause nausea, vomiting, diarrhea, and seizures (especially in renal impairment).
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Treatment: Symptomatic and supportive; consider hemodialysis for severe cases.
Therapeutic Class:
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First-generation cephalosporins
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Antibacterial (beta-lactam antibiotic)
Storage Conditions:
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Store below 25°C, protected from light and moisture.
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Reconstituted solutions (oral or injectable): Follow manufacturer’s instructions for storage duration.
Chemical Structure:
IUPAC Name:
(6R,7R)-7-[(2R)-2-Amino-2-phenylacetamido]-3-methyl-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
Molecular Formula: C16H19N3O4S
Molecular Weight: 349.41 g/mol