Getting It Right the Second Time: How Can we Optimize First‐Generation Cephalosporin Dosing for Skin and Soft Tissue Infections in the 21st Century?

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Abstract
Optimal cephalexin and cefadroxil dosing for skin and soft tissue infections (SSTIs) is unclear. We summarize clinical and pharmacokinetic/pharmacodynamic (PK/PD) data that compare dosing strategies for SSTIs. Additionally, we conduct population PK target attainment simulations for varying doses of cephalexin and cefadroxil for Staphylococcus aureus and Group A Streptococcus . Although some clinical data support lower doses in mild SSTIs, higher doses optimize PK/PD parameters in moderate–severe SSTIs, especially due to Staphylococcus aureus . Further prospective clinical and PK/PD studies, especially in obese adults, would be beneficial.

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