Training session 6

Droxyceph
Category :
Droxyceph contains Cefadroxil. Cefadroxil is a broadspectrum, first generation cephalosporin for oral use. It has a bactericidal action A broad spectrum of action indicates that Droxyceph is effective against both gram positive and gram negative microorganisms. As a first generation cephalosporin, it has more activity against gram positive pathogens. Droxyceph is mainly recommended as a first line antibiotic for the management of routine day to day infections of the respiratory tract urinary tract and skin infections .
Mechanism of action :
Droxyceph is a betalactam antibiotic. It inhibits the cell wall synthesis of the bacteria, thus killing the bacteria in the process. Detailed mechanism of action
Absorption :
Droxyceph is rapidly absorbed after oral administration.
If a single dose of 500mg of Droxyceph is administered orally, then the maximum concentration reached in the blood stream is approximately 16micrograms per ml of blood.
With a 1000mg oral dose of Droxyceph, the maximum concentration reached in the blood stream is approximately 28 micrograms per ml of blood.
The Droxyceph Advantage - Dose doubling, almost doubles the concentration in the bloodstream. You will appreciate that doctors will take advantage of this and prescribe 2 capsules of Droxyceph in specific infections where higher concentrations of the drug is required. This is commonly seen in urinary tract infections.
Excretion :
Droxyceph is excreted in urine
Over 90% of the drug is excreted unchanged in the urine.
A 500mg oral dose of Droxyceph will produce a urinary concentration of approximately 1800micrograms in each ml of urine
An increase in the dose will produce a proportionate increase in the urinary concentration
The Droxyceph Advantage: Since the active ingredient Cefadroxil is available unchanged in the urinary tract, Droxyceph is useful in the management of urinary tract infections.
A 1000mg oral dose of Droxyceph will produce a urinary concentration that will be much higher than the minimum concentration required to kill the urinary pathogens
This concentration is maintained for about 20 to 22 hours
Microbiology :
Droxyceph has in vitro and in vivo activity against the following microorganisms
Beta hemolytic streptococci Staphylococci Streptococcus pneumoniae Escherichia coli Klebsiella species Moraxella (Branhamella) catarrhalis
Indication and usage :
Pharyngitis Tonsillitis- caused by group A beta haemolytic streptococci Urinary Tract Infections- caused by klebsiella, E coli and Proteus mirabilis Skin and Skin Structure Infecions - caused by streptococci and staphylococci
Contraindications:
Known allergy to Cephalosporins.
Warnings :
In an individual who is allergic to beta lactam antibiotics, the probability of allergy manifestation to Cefadroxil is as high as10%.
Subsequent to the administration of Cefadroxil, patients who present with diarrhoea should be considered for diagnosis of pseudomembranous colitis.
Precautions :
Impaired renal function Super infection - prolonged use of Cefadroxil may result in the overgrowth of nonsusceptible organisms. This may lead to superinfection False positive Coomb's test Pregnancy and Lactation - Cefadroxil is not recommended in pregnancy and lactation
Adverse reactions :
Gastrointestinal - Nausea, vomiting, diarrhoea Hypersensitivity - Rash, urticaria, angioedema General - Pruritus, genital moniliasis, vaginitis, transient decrease in neutrophil count
Dosage:

CATEGORY	UTI	SKIN AND SKIN STRUCTURE INFECTIONS	PHARYNGITIS AND TONSILLITIS
ADULTS	1 or 2 grams per day in OD or BD doses	1 gram per day in OD or BD doses	1 gram per day in OD or BD doses for 10 days
CHILDREN	30mg/kg/day in divided doses, every 12 hours	30mg/kg/day in single or divided doses, every 12 hours	30mg/kg/day in divided doses, every 12 hours to be administered for 10 days

Product formulation :

Droxyceph(Cefadroxil) - 500 mg cap and 125/250 mg DT

Benefits :

Patient friendly dosing schedules - OD or BDs

Good activity against Streptococci - Hence valuable choice in Tonsillitis and Pharyngitis

Competitive pricing

First line antibiotic in the management of urinary tract infections caused by susceptible organisms

Competition :

Brand	Company
DROXYL	TORRENT
CEFADROX	ARISTO
ODOXIL	LUPIN
CEFADUR	CIPLA
VEPAN	INDOCO