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| Clinical data | |
|---|---|
| Trade names | Biocef, Ceclor, Medacef, Distaclor, Keflor, Raniclor |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682729 |
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| Routes of administration | Oral |
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| Pharmacokinetic data | |
| Bioavailability | Well absorbed, independent of food intake |
| Metabolism | 15% to 40% |
| Eliminationhalf-life | 0.6 to 0.9 hours |
| Excretion | Renal |
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| CAS Number | |
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| DrugBank |
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| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.053.536 |
| Chemical and physical data | |
| Formula | C15H14ClN3O4S |
| Molar mass | 367.80 g·mol−1 |
| 3D model (JSmol) | |
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Cefaclor, sold under the trade nameCeclor among others, is a second-generationcephalosporinantibiotic used to treat certainbacterial infections such aspneumonia and infections of the ear, lung, skin, throat, and urinary tract. It is also available from other manufacturers as a generic.[1]
It was patented in 1973 and approved for medical use in 1979.[2]
Cefaclor belongs to the family of antibiotics known as thecephalosporins (cefalosporins). The cephalosporins are broad-spectrumantibiotics that are used for the treatment ofsepticaemia,pneumonia,meningitis, biliary tract infections,peritonitis, and urinary tract infections. The pharmacology of the cephalosporins is similar to that of thepenicillins, excretion being principally renal. Cephalosporins penetrate thecerebrospinal fluid poorly unless the meninges are inflamed;cefotaxime is a more suitable cephalosporin than cefaclor for infections of thecentral nervous system, e.g.meningitis. Cefaclor is active against manybacteria, including bothGram-negative andGram-positive organisms.[citation needed]
Cefaclor is frequently used against bacteria responsible for causing skin infections, otitis media, urinary tract infections, and others. Cefaclor has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections: Gram positive aerobes - Staphylococci (including coagulase-positive, coagulase-negative, and penicillinase-producing strains), Streptococcus pneumoniae, and Streptococcus pyogenes (group A β-hemolytic streptococci).[3]The following represents MIC susceptibility data for a few medically significant microorganisms.
Cautions include known sensitivity to beta-lactam antibacterials, such as penicillins (Cefaclor should be avoided if there is a history of immediatehypersensitivity reaction); renal impairment (no dose adjustment required, although manufacturer advises caution);pregnancy andbreast-feeding (but appropriate to use); false positive urinary glucose (if tested for reducing substances) and false positiveCoombs test. Cefaclor has also been reported to cause aserum sickness-like reaction in children.[5][6]
Cefaclor is contraindicated in case of hypersensitivity (i.e. allergy) to cephalosporins.[citation needed]
The principalside effect of the cephalosporins is hypersensitivity. Penicillin-sensitive patients may also be allergic to the cephalosporins, depending on the side chain and it's relation to the penicillin allergy. Most patients with penicillin allergy can tolerate the majority of cephalosporins without allergic reactions. The previous percentage of 10% cross reactivity rates are a gross overestimation.[7] Allergic reactions may present as, for example, rashes,pruritus (itching),urticaria,serum sickness-like reactions with rashes, fever andarthralgia, andanaphylaxis. The frequency and severity ofserum sickness-like reactions in children has led researchers to question its role in pediatric illness.[8] Other side effects include gastrointestinal disturbances (e.g. diarrhea, nausea and vomiting, abdominal discomfort, disturbances in liver enzymes, transienthepatitis and cholestatic jaundice),headache, andStevens–Johnson syndrome. Rare side effects includeeosinophilia and blood disorders (includingthrombocytopenia,leucopenia,agranulocytosis,aplastic anaemia andhaemolytic anaemia); reversibleinterstitial nephritis;hyperactivity,nervousness, sleep disturbances,hallucinations,confusion,hypertonia, anddizziness.Toxic epidermal necrolysis has been reported. In the UK, The Committee on the Safety of Medicines (CSM) has warned that the risk of diarrhea and rarely antibiotic-associated colitis are more likely with higher doses.[citation needed]
Cefaclor is passed into thebreast milk in small quantities, but is generally accepted to be safe to take duringbreastfeeding.[9] Cefaclor is not known to be harmful inpregnancy.[10]
Cephalosporins possibly enhance theanticoagulant effect ofcoumarins (e.g.Warfarin) - change in patient's clinical condition, particularly associated with liver disease, intercurrent illness, or drug administration, necessitates more frequent testing ofINR, and dose adjustment as necessary.[citation needed]
Excretion ofcephalosporins is reduced byprobenecid (resulting in increased concentrations of drug in theblood plasma).[citation needed]
Absorption of cefaclor is reduced byantacids. Therefore antacids should not be taken right before or at the same time as cefaclor.[11][12]