St. Anger was Metallica’s best album

I’ll give a prize to anyone who can tell me how the title relates to cefadroxil. Seriously, I don’t know but I couldn’t think of a better title for a drug that sounds like a Pokémon or something. Actually, that is true and so is the title. Bingo bango. 

This time I won’t write a page of preamble before getting down to brass tacks. Cefadroxil, the brother of cephalexin, a beta lactam antibiotic, and a first generation cephalosporin. Case closed. 

What’s the difference between the two? Or between the other 657,326 other first gen cephalosporins? At least comparing cephalexin to cefadroxil there are a few differences. Cefadroxil is cleared slower or more slowly, or slowier from the body than the cephy. It is generally given Q12H or QD as opposed to Q6H to Q12H. Cefadroxil is given in higher doses (generally) 1-2g/day versus 1g/day. Both are time dependent mass killers of bacteria, kinda like when you spend too much time with that friend who doesn't shut up it ends up melting your brain. I am that friend by the way. 

They have the same spectrum of coverage, that includes MSSA, coagulase-negative Staph, Strep spp., E. coli, K. pneumoneiae, P. mirabilis, and others. Both are available as generics, generally well covered by insurance, and inexpensive otherwise. I bring that up because from what I see, cefadroxil and cephalexin are pretty much twins. 

I found an article asking the question I had, why do we use cephalexin more so? The price is generally the same and are both well covered according to the interwebs. What's the deal? I am thinking about patients who come into the clinic for skin auguries and get cephalexin made available for them depending on the risk of infection. Especially for patients with poly-pharmacy, do they need two more pills to take a day or just one? I am finding plenty of information on using first-generation cephalosporins but it seems to me like cephalexin is just used as a stand in. Can someone help me understand this? 

When I get back to work, I am going to ask the doc about this. It gives me plenty to think about in class, because I can't listen to this anymore. On the bright side, it has been bright and sunny so I have not kept up with the blogging as much. I also went to a fantastic concert by VV yesterday, 10/10 recommend. Such a silky smooth voice. I will try to post more regularly again, exams are next week and God willing I will take my boards soon after and won't have to take time to do school work. Have an excellent day, week, night, beer, or whatever your are having right now. Love y'all. 

References

Cephadroxil from Antimicrobe.org

Current Options for Acute Skin and Skin-structure Infections from Clinical Infectious Diseases 2019 by Yoav Golan.

IDSA guidelines for SSTIs 2014 update (is there a more updated update?) from, you guessed it 2014 by Stevens et al.

Image of different Strep cultures from Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin susceptible Staphylococcus aureus (MSSA) cause dermonecrosis and bacteremia in rats in the International Research Journal of Microbiology 2015.

Why isn't cefadroxil used more often? from the American Journal of Health-System Pharmacology in 2016 by Carson, Myers, and Dinges. 


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