Cefaclor
General
- Type: Second generation cephalosporin
- Dosage Forms: capsule, tablet, oral suspension
- Dosage Strengths: capsule: 250mg, 500mg; tablet 500mg; oral suspension: 125mg/5mL, 250mg/5mL, 375mg/5mL
- Routes of Administration: PO
- Common Trade Names: Ceclor, Raniclor
Adult Dosing
Infection, bacterial
- Immediate-release:
- 250-500 mg PO q8h
- Max: 2 g/day
- 250-500 mg PO q8h
- Extended-release:
- 500 mg ER PO q12h
- Max 2 g/day
- 500 mg ER PO q12h
Pediatric Dosing
Infection, bacterial
- 1+ mo
- 20-40 mg/kg/day PO divided 18-12h
- Max: 1 g/day
- 20-40 mg/kg/day PO divided 18-12h
Special Populations
- Pregnancy Rating: B
- Lactation: May use while breastfeeding
- Renal Dosing
- Adult:
- No adjustment
- HD: Give dose after dialysis
- PD: No supplement
- Pediatric
- CrCl <10: Decrease dose 50%
- HD: Give dose after dialysis
- PD: No supplement
- Adult:
- Hepatic Dosing
- Adult:
- Not defined
- Pediatric
- Not defined
- Adult:
Contraindications
- Allergy to class/drug
- Caution:
- Hypersensitivity to penicillin
- Renal impairment
- Concurrent nephrotoxic agent
- Seizure disorder
- Recent abx-associated colitis history
Adverse Reactions
Serious
- Anaphylaxis
- Thrombocytopenia
- Serum-sickness like reaction
- Seizure
- Nephrotoxicity
- Neutropenia
- Anemia, hemolytic
- Exfoliative dermatitis
- Stevens-Johnson Syndrome
- Superinfection
- C. difficile associated diarrhea
- Cholestatic jaundice
Pharmacology
- Half-life: 35-54 min; 2-3hr in ERSD
- Metabolism: Partial, hepatic
- Excretion: Urine primarily (60-85% unchanged)
- Mechanism of Action: Inhibits cell wall mucopeptide synthesis; bactericidal
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- Ahlfors CE. Benzyl alcohol, kernicterus, and unbound bilirubin. J Pediatr. 2001;139(2):317-319. [PubMed 11487763]
- American Thoracic Society, “Guidelines for the Initial Management of Adults With Community-Acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy,” Am Rev Respir Dis, 1993, 148(5):1418-26. [PubMed 8239186]
- Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007, p 61, 153.
- Boguniewicz M and Leung DYM, “Hypersensitivity Reactions to Antibiotics Commonly Used in Children,” Pediatr Infect Dis J, 1995, 14(3):221-31. [PubMed 7761188]
- Campagna JD, Bond MC, Schabelman E, Hayes BD. The use of cephalosporins in penicillin-allergic patients: a literature review. J Emerg Med. 2012; 42(5):612-620. [PubMed 21742459]
- Cefaclor Capsules [prescribing information]. Eatontown, NJ: West-Ward Pharmaceuticals; July 2015.
- Cefaclor Extended-Release Tablets [prescribing information]. North Wales, PA: Teva Pharmaceuticals; December 2014.
- Sanford Guide to Antimicrobial Therapy 2014
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