Cefaclor

Indications

Cefaclor is used for: Pneumonia, Meningitis, Peritonitis, Otitis media, Septicaemia, Biliary-tract infections, Urinary-tract infections, Skin and skin structure infections, Upper and lower respiratory tract infections, Pharyngitis and Tonsillitis

Adult Dose

Oral Urinary tract infections, Upper and lower respiratory tract infections, Skin infections, Otitis media Adult: As monohydrate: 250-500 mg every 8 hr. Max: 4 g daily.

Child Dose

Oral Urinary tract infections, Upper and lower respiratory tract infections, Skin infections, Otitis media Child: PO 20–40 mg/kg/day, max 1 g/day q12h 1-5 yr: 125 mg tid, >5 yr: 250 mg tid. Suspension & Paediatric Drops: 1 month - 1 year 2.5 ml t.i.d. 0.625 ml t.i.d 1 year - 5 year 5 ml t.i.d. 1.25 ml t.i.d over 5 years 10 ml t.i.d 2.5 ml t.i.d

Renal Dose

Renal Impairment CrCl: 10-50 mL/min: Half to full dose CrCl: <10 mL/min: Half dose

Administration

May be taken with or without food.

Contra Indications

Known hypersensitivity to cephalosporins.

Precautions

Severe renal impairment; history of allergy to penicillin; pregnancy, lactation. Lactation: enters breast milk; use with caution

Pregnancy-Lactation

Interactions

May enhance the nephrotoxic effect of aminoglycosides. May diminish the therapeutic effect of BCG, typhoid vaccine and Na picosulfate. Concomitant use w/ warfarin may increase prothrombin time. Probenecid inhibits renal excretion of cefaclor.

Adverse Effects

Side effects of Cefaclor : 1-10% Diarrhea (3%),Increased transaminases (3%),Eosinophilia (2%),Moniliasis (2%),Vaginitis (2%),Rash (maculopapular, erythematous, or morbiliform) (1-2%) <1% Stevens-Johnson syndrome,Pseudomembranous colitis,Nausea,Vomiting,Anemia,Neutropenia,Jaundice Potentially Fatal: Anaphylactic reaction; pseudomembranous colitis.

Mechanism of Action

Cefaclor binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. It has bactericidal activity against gm-ve bacteria including E. coli, S. pneumoniae, N. gonorrhoea, P. mirabilis and H. influenzae.