Cefaclor is a second-generation cephalosporin antibiotic indicated for the treatment of a wide range of bacterial infections. It exerts its bactericidal effect by inhibiting bacterial cell wall synthesis, making it a reliable choice for clinicians managing susceptible pathogens. This oral cephalosporin is particularly valued for its spectrum of activity against both gram-positive and gram-negative organisms, offering flexibility in outpatient and community settings.

Features

• Belongs to the second-generation cephalosporin class
• Available in 250 mg and 500 mg capsules, as well as oral suspension formulations
• Demonstrates stability against beta-lactamase produced by certain bacteria
• Oral bioavailability allows for convenient administration
• Exhibits activity against Haemophilus influenzae, including beta-lactamase-producing strains

Benefits

• Provides broad-spectrum coverage against common respiratory and skin pathogens
• Offers convenient twice-daily dosing for improved patient compliance
• Demonstrates reliable penetration into tissues and body fluids
• Shows effectiveness in pediatric populations with appropriate dosing
• Presents a well-tolerated profile for most patient populations
• Serves as an alternative for penicillin-allergic patients (with appropriate caution)

Common use

Cefaclor is commonly prescribed for bacterial pharyngitis, otitis media, lower respiratory tract infections including bronchitis and pneumonia, skin and soft tissue infections, and urinary tract infections caused by susceptible strains of microorganisms. It is particularly effective against Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus (penicillinase-producing), Escherichia coli, and Proteus mirabilis.

Dosage and direction

The usual adult dosage is 250 mg every 8 hours. For more severe infections or those caused by less susceptible organisms, doses may be increased to 500 mg every 8 hours. The maximum daily dose should not exceed 4 grams.

For pediatric patients, the recommended dosage is 20 mg/kg/day in divided doses every 8 hours. For more severe infections, 40 mg/kg/day may be administered, with a maximum daily dose of 1 gram.

The oral suspension should be shaken well before each use. Cefaclor may be taken without regard to meals, though administration with food may minimize gastrointestinal discomfort.

Precautions

Patients should complete the entire course of therapy even if symptoms improve to prevent development of resistant bacteria. Use with caution in patients with renal impairment; dosage adjustments may be necessary. Monitor for signs of superinfection during prolonged therapy. Pseudomembranous colitis has been reported with nearly all antibacterial agents, including cefaclor. Patients with history of gastrointestinal disease, particularly colitis, should be closely monitored.

Contraindications

Cefaclor is contraindicated in patients with known hypersensitivity to cephalosporin antibiotics. Cross-sensitivity may occur in patients allergic to penicillin; approximately 10% of penicillin-allergic patients will experience reactions to cephalosporins. Do not administer to patients who have experienced anaphylactic reactions to penicillins.

Possible side effect

Common adverse reactions include diarrhea (2-3%), nausea and vomiting (1-2%), and abdominal pain. Hypersensitivity reactions manifested by skin eruptions, urticaria, serum sickness-like reactions, and erythema multiforme may occur. Transient elevations in liver enzymes have been observed. Rare but serious side effects include pseudomembranous colitis, Stevens-Johnson syndrome, and blood dyscrasias.

Drug interaction

Probenecid may decrease renal tubular secretion of cefaclor, resulting in increased and prolonged blood levels. Concomitant use with potent diuretics may increase the risk of nephrotoxicity. Anticoagulant effects may be enhanced when administered with cefaclor. False-positive reactions for glucose in the urine may occur with Benedict’s or Fehling’s solutions but not with enzyme-based tests.

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 continue with the regular dosing schedule. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose may include nausea, vomiting, epigastric distress, and diarrhea. In case of suspected overdose, gastric lavage may be indicated. Cefaclor is eliminated primarily by the kidneys; hemodialysis may aid in removal of the drug from the body. Serum levels of cefaclor can be reduced by hemodialysis.

Storage

Store capsules at controlled room temperature (15-30°C or 59-86°F) in a tightly closed container. Keep oral suspension refrigerated and discard any unused portion after 14 days. Protect from moisture and light. Keep out of reach of children.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any new medication or treatment. The prescribing physician should be consulted regarding dosage adjustments based on individual patient characteristics and infection severity.

Reviews

Clinical studies have demonstrated cefaclor’s efficacy rates of 85-95% for respiratory tract infections when caused by susceptible organisms. The drug has shown particular effectiveness in pediatric otitis media, with success rates comparable to other cephalosporins. Many clinicians appreciate its convenient dosing schedule and generally favorable side effect profile. However, emerging resistance patterns have led to more selective use in recent years, particularly for respiratory infections where alternative agents may be preferred based on local susceptibility data.