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Comparative evaluation of cefadroxil and cephalexin in children and adolescents with pyodermas. Cefadroxil Once Daily
C W Linder1, K Nelson, S Paryani
1Medical College of Georgia, Augusta.
Insights
Once-daily cefadroxil demonstrated superior bacteriologic eradication and overall effective response compared to twice-daily cephalexin in treating pediatric pyodermas. This improved efficacy was linked to significantly better medication compliance with the single-dose regimen.
Area of Science:
- Pediatric Infectious Diseases
- Dermatology
- Pharmacology
Background:
- Pyodermas are common bacterial skin infections in children and adolescents.
- Gram-positive pathogens, primarily Staphylococcus aureus and Streptococcus pyogenes, are frequent causative agents.
- Standard treatment often involves cephalosporins, with varying dosing regimens.
Purpose of the Study:
- To compare the safety and efficacy of cefadroxil versus cephalexin for treating pyodermas in pediatric patients.
- To evaluate bacteriologic and clinical response rates between the two antibiotic treatments.
- To assess medication compliance and adverse events associated with different dosing frequencies.
Main Methods:
- A randomized, multicenter study involving children and adolescents aged 1-18 years.
- Cefadroxil administered as a single daily dose (30 mg/kg) versus cephalexin in divided doses (30 mg/kg/day).
- Evaluations included clinical and bacteriologic assessments during and after a 10-day treatment course.
Main Results:
- Cefadroxil showed a statistically greater bacteriologic response (96% vs. 89%; P = 0.042).
- Overall effective response was significantly higher with cefadroxil (94% vs. 86%; P = 0.024).
- Medication compliance was markedly better with once-daily cefadroxil (95% completion) than twice-daily cephalexin (65% completion; P < 0.0001).
Conclusions:
- Once-daily cefadroxil is a more effective treatment for pediatric pyodermas caused by gram-positive pathogens than twice-daily cephalexin.
- Improved compliance associated with the single-dose regimen likely contributes to enhanced treatment outcomes.
- Both antibiotics were generally safe and well-tolerated, with infrequent, mild adverse events.
Abstract:
This randomized, multicenter study compared the safety and efficacy of cefadroxil with that of cephalexin for the treatment of pyodermas in children and adolescents (1-18 years of age). Cefadroxil was given as a single oral daily dose of 30 mg/kg, and cephalexin 30 mg/kg/day was given in two divided doses. The maximum daily dose for both drugs was 1 gm, and treatment was administered for 10 days. Clinical and bacteriologic evaluations were made on days 4 or 5 during therapy and 2 to 4 days after therapy was completed. Of the 462 patients enrolled in the study, 156 patients in the cefadroxil group and 133 patients in the cephalexin group were evaluable. Staphylococcus aureus (56% of isolates) and Streptococcus pyogenes (39% of isolates) were isolated most frequently. The bacteriologic response was statistically greater in the patients treated with cefadroxil than in those treated with cephalexin (96% versus 89%; P = 0.042). A satisfactory clinical response was reported in 147 (94%) cefadroxil-treated patients and 122 (92%) cephalexin-treated patients (P = 0.476). The overall effective response to treatment was significantly higher with cefadroxil than with cephalexin (94% versus 86%; P = 0.024). Compliance with 9 or 10 days of therapy was similar in both treatment groups, although there was a difference between the two treatment groups with respect to completion of medication regimen: 95% of patients taking cefadroxil once daily--versus 65% of patients taking cephalexin twice daily--took 100% of their medication (P < 0.0001). Adverse events were infrequent and mild. The results of this study demonstrate that once-daily cefadroxil offers greater bacteriologic eradication and a better overall effective response than twice-daily cephalexin for the treatment of pyodermas caused by gram-positive pathogens in children and adolescents.