Cefaclor: Effective Second-Generation Cephalosporin Antibiotic Therapy
Cefaclor
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Cefaclor is a second-generation cephalosporin antibiotic indicated for the treatment of a wide range of bacterial infections caused by susceptible microorganisms. It exerts its bactericidal effect by inhibiting bacterial cell wall synthesis, leading to osmotic instability and cell lysis. This oral formulation offers a broad spectrum of coverage against both gram-positive and gram-negative bacteria, making it a versatile option in outpatient and community-acquired infection management. Its pharmacokinetic profile allows for convenient dosing schedules, supporting patient adherence and therapeutic success.
Features
- Chemical Classification: Second-generation cephalosporin antibiotic
- Mechanism of Action: Inhibition of bacterial cell wall synthesis via binding to penicillin-binding proteins (PBPs)
- Spectrum of Activity: Broad-spectrum; effective against many gram-positive and gram-negative aerobes
- Formulation: Available as capsules, tablets, and oral suspension
- Bioavailability: Well-absorbed from the gastrointestinal tract, unaffected by food
- Half-life: Approximately 0.6β0.9 hours in adults with normal renal function
- Metabolism: Minimally metabolized; primarily excreted unchanged in urine
- Pregnancy Category: B (Animal studies do not indicate direct or indirect harmful effects; human data limited)
Benefits
- Provides reliable bactericidal activity against common respiratory, skin, and urinary tract pathogens
- Offers convenient oral administration, facilitating outpatient treatment and reducing healthcare costs
- Demonstrates good tissue penetration, achieving effective concentrations at sites of infection
- Features a safety profile consistent with the cephalosporin class, generally well-tolerated in appropriate patient populations
- Allows for flexible dosing regimens that can be adjusted based on renal function and infection severity
- Serves as an important therapeutic option for patients with penicillin allergies (non-anaphylactic type)
Common use
Cefaclor is commonly prescribed for the treatment of mild to moderate infections caused by susceptible strains of microorganisms. Primary indications include acute bacterial exacerbations of chronic bronchitis, community-acquired pneumonia, pharyngitis, tonsillitis, otitis media, skin and skin structure infections, and uncomplicated urinary tract infections. It is particularly useful in outpatient settings where coverage for both Streptococcus pneumoniae and Haemophilus influenzae is required. Medical professionals may also consider it for prophylactic use in certain surgical procedures, though this is not a primary indication.
Dosage and direction
The dosage of cefaclor must be individualized based on the infection site, severity, and the patient’s renal function. For adults, the usual dose ranges from 250 mg to 500 mg every 8 hours. For more severe infections or those caused by less susceptible organisms, doses up to 1 gram every 8 hours may be required. Pediatric dosing is typically based on body weight, generally 20β40 mg/kg/day divided into two or three doses, not to exceed 1 gram per day. Administration with food may minimize potential gastrointestinal upset. The full prescribed course should be completed even if symptoms improve earlier to prevent recurrence and antibiotic resistance. Dosage adjustment is necessary in patients with renal impairment (creatinine clearance <50 mL/min).
Precautions
Before initiating cefaclor therapy, careful patient assessment is essential. Use with caution in patients with a history of gastrointestinal disease, particularly colitis, as antibiotic use may result in Clostridium difficile-associated diarrhea. Renal function should be assessed, especially in elderly patients or those with pre-existing renal impairment, as dosage adjustments may be necessary. Hepatic function monitoring is advised during prolonged therapy. As with all antibiotics, prolonged use may result in overgrowth of nonsusceptible organisms, including fungi. Patients should be advised to report any signs of superinfection promptly. Caution is advised when administering to patients with a history of hypersensitivity reactions to other beta-lactam antibiotics.
Contraindications
Cefaclor is contraindicated in patients with known hypersensitivity to cefaclor, other cephalosporins, or any component of the formulation. It should not be administered to patients who have experienced anaphylactic reactions to penicillins or other beta-lactam antibiotics due to the risk of cross-reactivity. The drug is also contraindicated in patients with a history of cefaclor-associated hemolytic anemia or other severe hematologic reactions. Use in patients with pre-existing severe renal impairment (without appropriate dosage adjustment) or hepatic failure may also represent a contraindication based on clinical judgment.
Possible side effect
The most commonly reported adverse reactions associated with cefaclor are gastrointestinal in nature, including diarrhea (up to 3%), nausea, vomiting, and abdominal pain. Hypersensitivity reactions may occur, manifesting as rash, urticaria, pruritus, and rarely, anaphylaxis. Other potential side effects include transient elevations in liver enzymes, eosinophilia, and positive direct Coombs’ test. Less frequently, patients may experience headache, dizziness, or vaginitis. Serious but rare adverse effects include pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and hemolytic anemia. Patients should be monitored for signs of these reactions throughout therapy.
Drug interaction
Cefaclor may interact with several medications, potentially altering their effects or increasing the risk of adverse reactions. Probenecid administration may result in increased and prolonged blood levels of cefaclor by inhibiting renal tubular secretion. Concurrent use with potent diuretics (e.g., furosemide, ethacrynic acid) may increase the risk of nephrotoxicity. Although clinical evidence is limited, interactions with oral anticoagulants may potentially enhance anticoagulant effects, requiring closer monitoring of coagulation parameters. The absorption of cefaclor may be reduced when taken with iron supplements or antacids containing magnesium or aluminum. Healthcare providers should review the patient’s complete medication regimen before prescribing.
Missed dose
If a dose of cefaclor is missed, it should be taken as soon as possible. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should be advised not to double the dose to make up for a missed one, as this may increase the risk of adverse effects. Maintaining consistent antibiotic levels is important for therapeutic efficacy, so patients should be encouraged to adhere strictly to the prescribed dosing schedule. Setting reminders or using pill organizers may help improve adherence, particularly for multiple daily dosing regimens.
Overdose
In cases of cefaclor overdose, symptoms may include nausea, vomiting, epigastric distress, and diarrhea. Neurological symptoms such as headache, dizziness, or paresthesia have been reported in some cases. Management should focus on supportive care, including maintenance of hydration and electrolyte balance. Gastric lavage may be considered if ingestion was recent. Hemodialysis may remove cefaclor from the circulation, particularly in patients with renal impairment, but is not routinely required. There is no specific antidote for cefaclor overdose. Patients should be monitored for signs of antibiotic-associated colitis or other serious adverse reactions that might be exacerbated by excessive dosing.
Storage
Cefaclor capsules and tablets should be stored at controlled room temperature, 20Β°C to 25Β°C (68Β°F to 77Β°F), in a tightly closed container, and protected from light and moisture. The oral suspension, once reconstituted, should be stored in the refrigerator (2Β°C to 8Β°C/36Β°F to 46Β°F) and discarded after 14 days. All medications should be kept out of reach of children and pets. Patients should be advised not to store cefaclor in bathroom cabinets where humidity and temperature fluctuations may degrade the product. Unused medication should be properly disposed of according to local regulations, not flushed down toilets or drains.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Cefaclor is a prescription medication that should only be used under the supervision of a qualified healthcare professional. The prescribing physician should be consulted for diagnosis, treatment decisions, and individualized dosing recommendations. Patients should not initiate, adjust, or discontinue cefaclor without medical supervision. While every effort has been made to ensure accuracy, medical knowledge is constantly evolving, and newer information may supersede what is presented here. Healthcare providers should reference the most current prescribing information and clinical guidelines when making treatment decisions.
Reviews
Clinical studies and post-marketing surveillance have demonstrated cefaclor’s efficacy in treating various bacterial infections, with success rates typically exceeding 85% in compliant patients. Medical professionals appreciate its reliable activity against common community-acquired pathogens and convenient dosing schedule. Some clinicians note the emergence of resistance in certain geographic areas, emphasizing the importance of culture and sensitivity testing when possible. Patient reviews frequently mention good tolerance, though gastrointestinal side effects are commonly reported. The drug’s position as a second-generation cephalosporin maintains its relevance in antimicrobial therapy, particularly for respiratory infections where its spectrum aligns well with common pathogens.