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:

  • Respiratory tract infections (e.g., pharyngitis, tonsillitis, bronchitis)

  • Otitis media

  • Skin and soft tissue infections

  • Urinary tract infections (UTIs)

  • Bone and joint infections

  • Post-operative and wound infections

Dosage & Administration:

Adults:

  • Upper respiratory infections, skin infections, and UTIs: 250–500 mg every 6 or 12 hours.

  • Severe infections or pneumonia: 1 g every 6–12 hours.

Children:

  • 25–50 mg/kg/day in divided doses every 6–12 hours.

  • Maximum: 100 mg/kg/day for severe infections.

Route: Oral or Intramuscular (IM) / Intravenous (IV)

Note: Adjust dose in renal impairment.

Interaction:

  • Probenecid: May increase and prolong blood levels of cephradine by reducing renal excretion.

  • May interfere with urine glucose tests (false positives with Benedict’s solution, Fehling’s solution).

  • Nephrotoxicity risk increases when combined with aminoglycosides or loop diuretics.

Contraindications:

  • Hypersensitivity to cephradine, other cephalosporins, or beta-lactam antibiotics (like penicillins).

Side Effects:

  • Common: Nausea, vomiting, diarrhea, abdominal pain

  • Allergic reactions: Rash, urticaria, anaphylaxis (rare)

  • Hematologic: Eosinophilia, neutropenia, thrombocytopenia (rare)

  • Renal: Transient elevations in BUN and creatinine

  • Superinfection: Including Clostridioides difficile–associated diarrhea (CDAD)

Pregnancy & Lactation:

  • Pregnancy Category B: Animal studies show no risk; no adequate studies in pregnant women. Use only if clearly needed.

  • Excreted in breast milk in small amounts; caution advised during lactation.

Precautions & Warnings:

  • Use cautiously in patients with renal impairment.

  • Cross-sensitivity with penicillins; avoid in known penicillin allergy.

  • Monitor for superinfections during prolonged use.

  • Use with caution in patients with gastrointestinal disease, especially colitis.

Overdose Effects:

  • May cause nausea, vomiting, diarrhea, and seizures (especially in renal impairment).

  • Treatment: Symptomatic and supportive; consider hemodialysis for severe cases.

Therapeutic Class:

  • First-generation cephalosporins

  • Antibacterial (beta-lactam antibiotic)

Storage Conditions:

  • Store below 25°C, protected from light and moisture.

  • 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

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