CEFACLOR

(sef'a-klor)

Ceclor, Ceclor CD
Classifications: antibiotic; second-generation cephalosporin;
Therapeutic: antibiotic; cephalosporin
Pregnancy Category: B

Availability

250 mg, 500 mg tablets; 375 mg, 500 mg sustained-release tablets; 125 mg/5 mL, 187 mg/5 mL, 250 mg/5 mL, 375 mg/5 mL suspension

Action

Semisynthetic, second-generation oral cephalosporin antibiotic. Possibly more active than other oral cephalosporins against gram-negative bacilli, especially beta-lactamase-producing Haemophilus influenzae, including ampicillin-resistant strains and certain gram-positive strains. Preferentially binds to one or more of the penicillin-binding proteins (PBPs) located on cell walls of susceptible organisms. This inhibits third and final stage of bacterial cell wall synthesis, thus killing the bacterium.

Therapeutic Effect

Effective in treating acute otitis media and acute sinusitis where the causative agent is resistant to other antibiotics. Useful in treating respiratory and urinary tract infections.

Uses

Treatment of otitis media and infections of upper and lower respiratory tract, urinary tract, and skin and skin structures caused by ampicillin-resistant H. influenzae; acute uncomplicated UTI.

Contraindications

Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B). Safe use in infants <1 mo not established.

Cautious Use

History of sensitivity to penicillins or other drug allergies; GI disease, colitis; markedly impaired renal function; older adults; coagulopathy; lactation.

Route & Dosage

Mild to Moderate Infections
Adult: PO 250–500 mg q8h, or Ceclor CD 250–500 mg/q12h
Child (>1 mo): PO 20–40 mg/kg/d divided q8h (max: 2 g/d)

Administration

Oral

Give sustained-release tablets with food to enhance absorption. Food does not affect absorption of capsules.
Ensure that sustained-release tablets are not chewed or crushed. They must be swallowed whole.
After stock oral suspension is prepared, it should be kept refrigerated. Expiration date should appear on label. Discard unused portion after 14 d. Shake well before pouring.
Store pulvules in tightly closed container unless otherwise directed.

Adverse Effects (≥1%)

Body as a Whole: Serum sickness-like reaction, eosinophilia, joint pain or swelling, fever, superinfections. GI: Diarrhea, nausea, vomiting, anorexia, pseudomembranous colitis (rare). Skin: Urticaria, pruritus, morbilliform eruptions.

Diagnostic Test Interference

Cefaclor may produce positive direct Coombs' test, which can complicate cross-matching procedures and hematologic studies. False-positive urine glucose determinations may result with use of copper sulfate reduction methods (e.g., Clinitest or Benedict's reagent) but not with glucose oxidase (enzymatic) tests such as Clinistix, Diastix, TesTape.

Interactions

Drug: Probenecid decreases renal excretion of cefaclor.

Pharmacokinetics

Absorption: Well absorbed; acid stable. Peak: 30–60 min. Elimination: 60% of dose eliminated renally in 8 h; crosses placenta; excreted in breast milk. Half-Life: 0.5–1 h.

Nursing Implications

Assessment & Drug Effects

Determine previous hypersensitivity to cephalosporins, penicillins, and other drug allergies before therapy is initiated.
Lab tests: Perform culture and sensitivity tests prior to and periodically during therapy.
Diarrhea, the most frequent adverse effect, may be due to a pharmacologic effect or to associated change in intestinal flora. If it persists, interruption of therapy may be necessary.
Monitor for manifestations of drug hypersensitivity (see Appendix F). Discontinue drug and promptly report them if they appear.
Monitor for manifestations of superinfection (see Appendix F). Promptly report their appearance.

Patient & Family Education

Report promptly any signs or symptoms of superinfection (see Appendix F).
Yogurt or buttermilk (if allowed) may serve as a prophylactic against intestinal superinfections by helping to maintain normal intestinal flora.
Take your medication for the full course of therapy as directed by physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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