Cefaclor: Effective Second-Generation Cephalosporin Antibiotic
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Cefaclor is a second-generation cephalosporin antibiotic designed to combat a wide spectrum of bacterial infections. It operates by inhibiting bacterial cell wall synthesis, leading to the eradication of susceptible pathogens. This oral medication is a trusted choice for healthcare providers treating common community-acquired infections, offering reliable efficacy with a well-understood safety profile. Its pharmacokinetic properties ensure adequate tissue penetration, making it suitable for various indications where bacterial resistance to first-line treatments is a concern.
Features
- Chemical Classification: Second-generation cephalosporin antibiotic
- Administration: Oral formulation (capsules, tablets, oral suspension)
- Mechanism of Action: Inhibition of bacterial cell wall synthesis via binding to penicillin-binding proteins (PBPs)
- Spectrum of Activity: Effective against Gram-positive and Gram-negative bacteria, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus (methicillin-susceptible), and Escherichia coli
- Bioavailability: Well-absorbed from the gastrointestinal tract, with peak serum concentrations achieved within 30–60 minutes
- Half-life: Approximately 0.5–1 hour in adults with normal renal function
- Excretion: Primarily renal, requiring dosage adjustment in renal impairment
Benefits
- Provides broad-spectrum coverage against common pathogens responsible for respiratory, skin, and urinary tract infections
- Oral bioavailability allows for convenient outpatient treatment, supporting patient compliance and reducing hospitalization needs
- Demonstrated efficacy in pediatric populations, with a palatable suspension formulation improving adherence in children
- Lower incidence of cross-resistance compared to some earlier-generation antibiotics, offering a reliable alternative in empiric therapy
- Well-tolerated profile with a lower risk of severe adverse effects relative to broader-spectrum agents, supporting its use in community settings
Common use
Cefaclor is indicated for the treatment of bacterial infections caused by susceptible strains of designated microorganisms. Common uses include:
- Pharyngitis and tonsillitis
- Otitis media
- Acute bacterial exacerbations of chronic bronchitis
- Pneumonia (community-acquired)
- Skin and skin structure infections
- Urinary tract infections (uncomplicated)
Dosage and direction
Dosage should be individualized based on the infection’s severity, pathogen susceptibility, and the patient’s renal function.
Adults:
The usual adult dosage is 250 mg every 8 hours. For more severe infections, 500 mg every 8 hours may be administered. Maximum daily dose should not exceed 4 g.
Pediatric Patients:
The recommended daily dosage for children is 20–40 mg/kg/day in divided doses every 8–12 hours, depending on infection severity. Maximum pediatric dose should not exceed 1 g per day.
Administration:
Cefaclor should be taken orally, with or without food, to minimize gastrointestinal upset. For patients with renal impairment (creatinine clearance <50 mL/min), dosage adjustments are necessary; consult prescribing information.
Precautions
- Use with caution in patients with a history of gastrointestinal disease, particularly colitis, due to the risk of antibiotic-associated colitis
- Prolonged use may result in the overgrowth of nonsusceptible organisms, including fungi; monitor for superinfection
- Perform culture and susceptibility testing to confirm pathogen susceptibility before initiating therapy, where practicable
- Use in pregnancy only if clearly needed; cefaclor crosses the placental barrier—Category B
- Exercise caution in breastfeeding women; cefaclor is excreted in human milk
Contraindications
Cefaclor is contraindicated in patients with known hypersensitivity to cefaclor, other cephalosporins, or any component of the formulation. Cross-sensitivity with penicillins may occur; caution is advised in patients with penicillin allergy.
Possible side effect
Common adverse reactions (≥1%) may include:
- Diarrhea
- Nausea
- Vomiting
- Abdominal pain
- Rash
- Pruritus
Less common but serious side effects:
- Clostridium difficile-associated diarrhea
- Hypersensitivity reactions (e.g., urticaria, anaphylaxis)
- Transient elevations in liver enzymes
- Hematologic effects (e.g., eosinophilia, neutropenia)
Drug interaction
- Probenecid: May inhibit renal excretion of cefaclor, increasing serum concentrations
- Oral anticoagulants: Potential enhancement of anticoagulant effect; monitor prothrombin time
- Chloramphenicol: Antagonistic in vitro; avoid concomitant use
Missed dose
If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to catch up.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric distress, and diarrhea. In cases of significant overdose, hemodialysis may aid in removal. Treatment should be supportive and symptomatic.
Storage
Store at controlled room temperature (20–25°C or 68–77°F). Protect from moisture. Keep oral suspension refrigerated after reconstitution; discard unused portion after 14 days.
Disclaimer
This information is intended for medical professionals and should not replace professional medical advice, diagnosis, or treatment. Always consult a healthcare provider for personalized recommendations and to confirm the suitability of cefaclor for a specific patient.
Reviews
Cefaclor is widely regarded in clinical practice for its efficacy in treating common bacterial infections, particularly in outpatient settings. Healthcare providers appreciate its reliability for respiratory and skin infections, though some note the necessity for susceptibility testing in areas with emerging resistance. Patient feedback often highlights the convenience of oral dosing, though gastrointestinal side effects are occasionally reported. Overall, it remains a valuable option within the cephalosporin class.