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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › OTHER BETA-LACTAM ANTIBACTERIALS › Second-generation cephalosporins
cefaclor
J01DC04
Forms & Strengths
- Capsules: 250 mg, 500 mg
- Oral suspension: 125 mg/5 mL, 250 mg/5 mL, 375 mg/5 mL
- Extended-release tablets: 500 mg
Adult Dosing
- Acute bronchitis / Pneumonia: 250 to 500 mg PO every 8 hours
- Pharyngitis / Tonsillitis / Urinary tract infections: 250 mg PO every 8 hours or 500 mg PO every 12 hours (extended-release)
- Skin and skin structure infections: 250 to 500 mg PO every 8 hours
- Maximum daily dose: 4 g/day
Pediatric Dosing
- Infants and children >= 1 month: 20 to 40 mg/kg/day PO divided every 8 to 12 hours
- Otitis media / Severe infections: 40 mg/kg/day PO divided every 8 hours
- Maximum daily dose: 1 g/day
Indications
- Acute bacterial exacerbations of chronic bronchitis
- Pharyngitis and tonsillitis caused by Streptococcus pyogenes
- Pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus
- Skin and skin structure infections caused by Staphylococcus aureus and Streptococcus pyogenes
- Urinary tract infections caused by E. coli, P. mirabilis, and Klebsiella species
- Acute otitis media caused by S. pneumoniae, H. influenzae, and M. catarrhalis
Mechanism of Action
- Second-generation cephalosporin beta-lactam antibiotic
- Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
- Leads to inhibition of cell wall peptidoglycan synthesis and subsequent bacterial cell lysis
Contraindications
- Known hypersensitivity to cefaclor, cephalosporins, or any component of the formulation
- History of immediate hypersensitivity reactions (e.g., anaphylaxis) to penicillins or other beta-lactam antibiotics
Adverse Reactions
- Diarrhea, nausea, vomiting, abdominal pain
- Hypersensitivity reactions: rash, urticaria, pruritus, serum sickness-like reactions (more common in children)
- Eosinophilia, transient elevations in liver enzymes (AST, ALT, alkaline phosphatase)
- Vaginitis, moniliasis
- Rare: Clostridioides difficile-associated diarrhea, anaphylaxis, Stevens-Johnson syndrome
Drug Interactions
- Antacids containing magnesium or aluminum may reduce the absorption rate of cefaclor
- Probenecid decreases renal tubular secretion of cephalosporins, increasing serum concentrations
- May enhance the anticoagulant effect of vitamin K antagonists (e.g., warfarin)
- False-positive direct Coombs test and false-positive reactions for glucose in urine using copper reduction methods (Benedict's test)
Curated Content: Needs Vetting Before Put to Clinical Use