Pneumonia, Pharyngitis, Susceptible infections, Otitis media, Skin and Skin-Structure Infections, Rheumatic fever, Tonsillitis, Respiratory tract infections, Urinary tract infections, Surgical Prophylaxis, Genitourinary tract infections, Acute prostatitis Hypersensitivity to cefradine or other cephalosporins; porphyria.

First generation Cephalosporins

Cephradine is a cephalosporin antibiotic with broad spectrum bactericidal activity against both gram-positive and gram-negative bacteria. Cephradine interferes with the synthesis of bacterial cell wall by inhibiting transpeptidase enzyme. As a result the bacterial cell wall is weakened, the cell swells and then ruptures.

Administration: May be taken with or without food. May be taken w/ 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 for inj or NaCl 0.9% inj to 500 mg or 1 g vial, respectively. IV: Add 5 mL of sterile water for inj, dextrose 5% inj, NaCl 0.9% inj or other suitable soln to 500 mg vial. Shake well the entire soln. Adult Dose: Adult: PO Susceptible infections 1-2 g/day in 2-4 divided doses. Max: 4 g/day. Surgical prophylaxis 1-2 g pre-op. Subsequent doses may be given as needed. Skin and skin structures and respiratory tract infection: Usual dose is 250 mg every 6 hours or 500 mg every 12 hours. Lobar pneumonia: 500 mg every 6 hours or 1 gm every 12 hours. Urinary tract infection: Usual dose is 500 mg every 12 hours. Gastro-intestinal tract infection: 500 mg three to four times daily. IV/IM Severe infections 2-4 g/day in 4 divided doses. Max: 8 g/day. Child Dose: Children: Oral: The usual total dose is 25 to 50 mg/kg/day given in 2 to 4 equally divided doses. Injection: 50 to 100 mg/kg/day in 4 equally divided doses. The usual total dose may be increased up to 200-300 mg/kg/day. Perioperative prophylaxis: Recommended dose is 1-2 gm by intramuscular or intravenous route; subsequent parenteral or oral doses are given as appropriate. Renal Dose: Renal impairment: For patients undergoing chronic intermittent haemodialysis: 250 mg may be given at the start of the session, repeated after 6-12 hr, then again 36-48 hr after the initial dose, and again at the start of the next haemodialysis if >30 hr have elapsed since the previous dose. CrCl (ml/min) >20 500 mg every 6 hr. 5-20 250 mg every 6 hr. <5 250 mg every 12 hr.

Increased risk of nephrotoxicity w/ loop diuretics. Decreased renal clearance w/ probenecid.

Hypersensitivity to cefradine or other cephalosporins; porphyria.

Diarrhoea, nausea, vomiting; leukopenia, neutropenia, eosinophilia, rash, pruritus; joint pain; increased BUN and creatine; dizziness. Potentially Fatal: Pseudomembranous colitis.

US FDA Pregnancy Category of Cefradine is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefradine have been shown to be excreted in human milk. So, caution should be exercised when Cefradine is administered to a nursing woman.

Precaution: Renal impairment; history of penicillin sensitivity; pregnancy; lactation.

The symptoms of Sefrad overdose are non-specific and are generally nausea, vomiting, diarrhoea 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 if kept at room temperature or within 14 days, if kept in a refrigerator. Cephradine Injection solutions should be used within 2 hours when kept at room temperature. When stored at 5°C, solutions retain potency for 12 hours. Reconstituted solutions may vary in colour from light to straw yellow; however, this does not affect the potency. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician

First generation Cephalosporins

Cefradine 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.

Although animal studies have not demonstrated any teratogenicity, safety in pregnancy has not been established. Cephradine is excreted in breast milk and should be used with caution in lactating mothers. Since the medicine may cause dizziness, patients should be cautioned about operating hazardous machinery, including automobiles.