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. Available in various formulations including capsules, tablets, and oral suspension, cefaclor offers flexibility in dosing for both adult and pediatric populations. Its spectrum of activity covers many common Gram-positive and Gram-negative organisms, providing a robust therapeutic option in outpatient and select inpatient settings.

Features

• Second-generation cephalosporin antibiotic
• Available in 250 mg and 500 mg capsules, tablets, and oral suspension
• Bactericidal activity through inhibition of cell wall synthesis
• Acid-stable for reliable oral absorption
• Broad spectrum covering common respiratory, skin, and urinary pathogens

Benefits

• Effectively treats bacterial infections while minimizing the risk of resistance development when used appropriately
• Convenient oral administration avoids the need for intravenous access in many cases
• Flexible dosing options accommodate both adult and pediatric patients
• Demonstrated clinical efficacy against common community-acquired pathogens
• Generally well-tolerated profile with predictable pharmacokinetics

Common use

Cefaclor is commonly prescribed for bacterial infections caused by susceptible strains of microorganisms. Typical indications include pharyngitis and tonsillitis caused by Streptococcus pyogenes, otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, and staphylococci, lower respiratory tract infections including pneumonia caused by S. pneumoniae, H. influenzae, and S. pyogenes, urinary tract infections caused by Escherichia coli, Proteus mirabilis, Klebsiella species, and coagulase-negative staphylococci, and skin and skin structure infections caused by S. aureus and S. pyogenes. The selection of cefaclor should be based on susceptibility testing whenever possible to ensure appropriate antimicrobial stewardship.

Dosage and direction

The dosage of cefaclor varies based on the infection being treated, severity of infection, and the patient’s renal function. For adults, the usual dose ranges from 250 mg to 500 mg every 8 hours. For more severe infections or those caused by less susceptible organisms, doses up to 1 gram every 8 hours may be required. Pediatric dosing is typically based on body weight at 20-40 mg/kg/day divided into two or three doses, not to exceed 1 gram per day. The oral suspension should be shaken well before each use. Cefaclor may be taken with or without food, though administration with food may help minimize gastrointestinal upset. Complete the full course of therapy even if symptoms improve before the medication is finished.

Precautions

Before prescribing cefaclor, carefully consider the patient’s allergy history, particularly regarding penicillin or other beta-lactam antibiotics due to possible cross-reactivity. Use with caution in patients with renal impairment; dosage adjustments are necessary for creatinine clearance below 50 mL/min. Monitor patients for the development of superinfections or pseudomembranous colitis, which may occur during or after antibiotic treatment. Exercise caution in patients with gastrointestinal disease, particularly colitis. Prolonged use may result in overgrowth of nonsusceptible organisms. Perform periodic assessment of renal and hematopoietic function during prolonged therapy.

Contraindications

Cefaclor is contraindicated in patients with known hypersensitivity to cefaclor or other cephalosporin antibiotics. It should not be administered to patients who have experienced anaphylactic reactions to penicillins due to the potential for cross-reactivity. The medication is contraindicated in patients with a history of severe immediate hypersensitivity reactions to any beta-lactam antibiotics. Do not use in cases where the infection is caused by organisms not susceptible to cefaclor’s spectrum of activity.

Possible side effect

Common adverse reactions include gastrointestinal disturbances such as diarrhea (2-3%), nausea (1-2%), and vomiting (1%). Dermatological reactions including rash and urticaria occur in approximately 1.5% of patients. Transient elevations in liver enzymes may be observed in some patients. Less frequently, patients may experience headache, dizziness, or reversible interstitial nephritis. Hypersensitivity reactions ranging from mild rash to anaphylaxis may occur. As with other broad-spectrum antibiotics, pseudomembranous colitis caused by Clostridium difficile has been reported. Hematologic effects including transient neutropenia, leukopenia, and thrombocytopenia have been observed in some patients.

Drug interaction

Probenecid may decrease renal tubular secretion of cefaclor, resulting in increased and prolonged blood levels. Concomitant use with nephrotoxic drugs may increase the risk of renal toxicity. Cefaclor may enhance the anticoagulant effect of warfarin; monitor prothrombin time closely in patients receiving both medications. The absorption of cefaclor may be reduced when taken with antacids containing aluminum or magnesium. Laboratory test interactions may occur, including false-positive reactions for glucose in the urine using copper reduction tests and false-positive direct Coombs test.

Missed dose

If a dose is missed, it should be taken as soon as possible. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Maintaining consistent blood levels of the antibiotic is important for therapeutic efficacy, so patients should be instructed to take the medication at evenly spaced intervals throughout the day.

Overdose

Symptoms of cefaclor overdose may include nausea, vomiting, epigastric distress, and diarrhea. In cases of significant overdose, seizures may occur, particularly in patients with renal impairment. Management should include symptomatic and supportive care. Gastric lavage may be beneficial if performed soon after ingestion. Hemodialysis may be effective in removing cefaclor from the bloodstream, particularly in patients with renal impairment. Monitor renal function and provide appropriate electrolyte replacement if significant diarrhea or vomiting occurs.

Storage

Store cefaclor capsules and tablets at controlled room temperature between 20°C to 25°C (68°F to 77°F) in a tightly closed container. Protect from moisture and light. The oral suspension, once reconstituted, should be stored in the refrigerator between 2°C to 8°C (36°F to 46°F) and discarded after 14 days. Keep all medications out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. The prescribing physician should be consulted for specific medical advice, diagnoses, and treatment recommendations. Dosage and administration should be determined by a qualified healthcare professional based on the individual patient’s condition, susceptibility of the causative organisms, and renal function. The complete prescribing information should be reviewed before initiating therapy with cefaclor.

Reviews

Clinical studies have demonstrated cefaclor’s efficacy in treating various bacterial infections with success rates typically exceeding 85% for approved indications. The medication is generally well-tolerated, with most adverse effects being mild and self-limiting. Healthcare providers appreciate its convenient dosing schedule and broad spectrum of activity against common pathogens. Patient satisfaction surveys indicate good tolerability and effectiveness, though some reports note gastrointestinal side effects as the most common reason for discontinuation. Continued susceptibility monitoring confirms that cefaclor remains an important therapeutic option in appropriate clinical scenarios.