Cefaclor and its Spectrum of activity

Cefaclor sold under the trade names Ceclor among others, is a second-generation cephalosporin antibiotic used to treat certain bacterial infections such as pneumonia and infections of the ears, lungs, skin, throat and urinary tract.It is also available from other manufacturers as a generic product.It was patented in 1973 and approved for medical use in 1979.

Medical uses

Cefaclor belongs to the family of antibiotics known as cephalosporins (cefalosporins).Cephalosporins are broad-spectrum antibiotics used to treat sepsis, pneumonia, meningitis, biliary tract infections, peritonitis, and urinary tract infections.The pharmacology of cephalosporins is similar to that of penicillins, and they are mainly excreted by the kidneys. Cefotaxime is a better cephalosporin than cefaclor for CNS infections, such as meningitis, unless the meninges are inflamed.Cefaclor is active against many bacteria, including Gram-negative and Gram-positive organisms.

Spectrum of activity

Cefaclor is often used against bacteria that cause skin infections, ear infections, urinary tract infections, etc.Cefaclor has been shown to be active against most strains of the following microorganisms, including in vitro and clinical infections:Gram-positive aerobic bacteria staphylococci (including coagulase-positive, coagulase-negative, and penicillinase-producing strains), pneumonia Streptococcus and Streptococcus pyogenes (group A beta-hemolytic streptococci).The following are MIC susceptibility data for some microorganisms of medical significance.

• Haemophilus influenzae: 0.03 μg/mL – 128 μg/mL

• Staphylococcus aureus: 0.6 μg/mL – 128 μg/mL

• Streptococcus pyogenes: 0.06 μg/mL – 4 μg/mL

Precautions and contraindications

Precautions include known sensitivity to beta-lactam antimicrobials, such as penicillin (cefixaclor should be avoided if history of immediate hypersensitivity reaction); renal impairment (no dose adjustment required, although manufacturer advises caution); Pregnancy and breastfeeding (but suitable for use); false positive urine glucose (if testing reducing substances) and false positive Coombs test. Cefaclor has also been reported to cause serum sickness-like reactions in children.Cefaclor is contraindicated in case of hypersensitivity (i.e. hypersensitivity) to cephalosporins.

Side effects

The main side effect of cephalosporins is hypersensitivity.Patients sensitive to penicillins are also allergic to cephalosporins, depending on the generation of the cephalosporin.The previous percent cross-reactivity rate of 10% is generally overestimated.Hypersensitivity reactions can manifest, for example, as rash, pruritus (itching), hives, serum sickness-like reaction with rash, fever and joint pain, and anaphylaxis.The frequency and severity of serum sickness-like reactions in children has led researchers to question its role in pediatric disease.Other side effects include gastrointestinal distress (eg, diarrhea, nausea and vomiting, abdominal discomfort, liver enzyme disturbances, transient hepatitis, and cholestatic jaundice), headache, and Stevens-Johnson syndrome.Rare side effects include eosinophilia and blood disorders (including thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, and hemolytic anemia); reversible interstitial nephritis; hyperactivity, nervousness, sleepiness Disorders, hallucinations, confusion, hypertonia, and dizziness. Toxic epidermal necrolysis has been reported.In the UK, the Committee on the Safety of Medicines (CSM) warns of a higher risk of diarrhea and a rare antibiotic-associated colitis from higher doses.

Interactions

Coumarins:

Cephalosporins may potentiate the anticoagulant effect of coumarins (e.g. warfarin) Changes in the patient’s clinical status, especially those related to liver disease, co-morbidities, or drug administration, require more frequent INR testing,And adjust the dose as needed. 

Probenecid

Probenecid reduces the excretion of cephalosporins (leading to an increase in the concentration of the drug in the plasma).

Antacids

Antacids reduce the absorption of cefaclor.Therefore, antacids should not be taken before or at the same time as cefaclor.