cefprozil
Regulatory sources consulted
Approved indications
- Mild-to-moderate susceptible upper- and lower-respiratory and skin infections.
Contraindications
Absolute
- Hypersensitivity to cefprozil or cephalosporins.
Clinical warnings
- Major warning · It may cause severe hypersensitivity or anaphylaxis. Review any history of immediate beta-lactam reactions before use and discontinue if an allergic reaction occurs. — FDA, set_id 14527f4a-ce99-449d-a5a5-9edd7fb28dee
- Major warning · It may cause Clostridioides difficile-associated diarrhea during or after treatment; assess significant diarrhea and avoid antiperistaltic drugs if colitis is suspected. — FDA, set_id 14527f4a-ce99-449d-a5a5-9edd7fb28dee
Drug interactions
- ModerateProbenecid
Mechanism: It reduces renal tubular secretion and may increase and prolong antibiotic exposure.
Recommendation: Avoid the combination unless deliberately indicated and monitor toxicity.
FDA, set_id 14527f4a-ce99-449d-a5a5-9edd7fb28dee
- HighAminoglycosides and other nephrotoxic drugs
Mechanism: The combination may increase nephrotoxicity.
Recommendation: Avoid the combination when possible and monitor renal function.
FDA, set_id 14527f4a-ce99-449d-a5a5-9edd7fb28dee
Adverse events
Common (≥1%)
Nausea, diarrhea, and rash
Rare but serious
Anaphylaxis, C. difficile colitis, and severe cytopenias
Pregnancy and lactation
Use during pregnancy only when clearly indicated. Small amounts pass into milk; monitor the infant for diarrhea, candidiasis, or sensitization and assess continuation according to the product.
Recent literature (PubMed)
This study aimed to assess the bioequivalence of 2 cefprozil dispersible tablet formulations (250 mg) in healthy Chinese volunteers under fasting and fed conditions and to determine the pharmacokinetics of cefprozil. A randomized, single-dose, open-label, 2-formulation, 2-period study was conducted. The elimination period for this study was 7 days. Forty-eight healthy volunteers received 250-mg cefprozil dispersible tablets in each study period under both test and reference conditions. The test and the reference cefprozil were bioequivalent in healthy Chinese volunteers, and there was no significant food effect in individuals receiving either formulation. No serious adverse event was recorded, and no volunteers withdrew from the study.
Penicillin remains the first-line therapy for group A streptococcal (GAS) pharyngitis. However, broad-spectrum antibiotics continue to be widely prescribed in clinical practice. This study aimed to evaluate the relative efficacy and safety profiles of antibiotics for GAS pharyngitis. Literature published through March 2026 was searched. Efficacy outcomes included early and late bacterial eradication, clinical response, and bacteriological recurrence, whereas safety was assessed according to adverse events. Per-protocol data were extracted, and a Bayesian network meta-analysis was performed to estimate pooled odds ratios (ORs) with 95% confidence intervals (CIs). We identified 64 RCTs (23,287 participants). For early bacterial eradication, cefdinir (OR: 3.09; 95% CI: 1.60-6.01) and cefpodoxime proxetil (OR: 2.58; 95% CI: 1.07-6.17) demonstrated greater efficacy compared with penicillin V, whereas azithromycin showed inferior eradication rates than penicillin V (OR: 0.53; 95% CI: 0.32-0.90). For late bacterial eradication, cefprozil demonstrated greater efficacy compared with penicillin V (OR: 3.12; 95% CI: 1.03-11.25), whereas azithromycin exhibited suboptimal performance (OR: 0.38; 95% CI: 0.25-0.62). For early clinical response, cefdinir (OR: 2.01; 95% CI: 1.28-3.25) and cefuroxime axetil (OR: 2.14; 95% CI: 1.19-3.60) demonstrated significantly greater efficacy compared with penicillin V. For late clinical response, spiramycin showed superior efficacy to penicillin V (OR: 0.17; 95% CI: 0.02-0.94), although evidence was limited to a single small trial. Azithromycin was associated with reduced efficacy, higher late recurrence rates, and increased adverse events. Standard penicillins should remain the preferred first-line therapy for GAS pharyngitis to support antimicrobial stewardship. Cefdinir represents an effective alternative. Conversely, azithromycin should be avoided due to inferior efficacy and increased adverse risks. http://www.crd.york.ac.uk/prospero, ident