Duke University Hospital Duke Raleigh Hospital Duke Regional Hospital

Usual Dose & Administration

500 mg PO q12h

Adjustment of Dose & Administration

Indication-Specific Adjustment

For UTI use, only use cefadroxil IF cefazolin MIC ≤ 2 mcg/mL (see below for further details)

Renal Adjustment

Indication CrCl ≥ 40 mL/min CrCl 20-40 mL/min CrCl < 20 mL/min
SSTI, uncomplicated UTI/cystitis 500 mg PO q12h 500 mg PO q24h 500 mg PO q48h
Complicated UTI, pyelonephritis 1000 mg PO q12h 500 mg PO q12h 500 mg PO q24h

 

Drug-Specific Information

CLSI recommends using cefazolin as a surrogate test for oral cephalosporins and uncomplicated UTIs. Cefadroxil is NOT one of the oral cephalosporins listed by CLSI due to lower cefazolin surrogate accuracy (91.6%) at a breakpoint ≤ 16 mcg/mL. However, cefazolin surrogate test accuracy improves to ~100% for cefadroxil when using a cefazolin breakpoint ≤ 2 mcg/mL (Diagn Microbiol Infect Dis 2020). Urine culture reporting at DUHS uses a cefazolin breakpoint ≤ 2 mcg/mL in E. coli, K. pneumoniae, and P. mirabilis to categorize susceptible (S) isolates.

Cost Index

$ (1-10)

General Notes

  1. Up to date cost information for select antimicrobials can be found on the Antimicrobial Cost Chart page.
  2. Information about how to administer select IV antimicrobials outpatient (OPAT) is found on the Outpatient Antibiotic Administration Chart page.
  3. When dosing guidance is provided it is important to note the following:

Fixed (i.e. non-weight-based) doses in adults are historically based on a 70 kg patient. Specific disease states or individual patients may warrant dosages that differ from the above recommendations. Since product-specific criteria for dose adjustment based on creatinine clearance exist, consult product information regarding specific recommendations for dosage adjustment based on estimated creatinine clearance.