Classifications: antibiotic; beta-lactam; second-generation cephalosporin; Therapeutic: antibiotic; cephalosporin
Pregnancy Category: B
200 mg, 400 mg capsules; 100 mg/5 mL, 200 mg/5 mL suspension
Second-generation cephalosporin antibiotic with drug structure characterized by a beta-lactam ring that inhibits cell wall
synthesis of bacteria. By preferentially binding to penicillin-binding proteins (PBPs) located inside the bacterial cell
wall, loracarbef inhibits the third and final stage of bacterial cell wall synthesis. Penicillin-binding proteins (PBPs)
are responsible for several steps in the synthesis of the bacterial cell wall. This interference results in cell death of
Effective against gram-positive and gram-negative bacteria.
Upper and lower respiratory tract infections, skin and skin structure infections, urinary tract infections.
Hypersensitivity to cephalosporins and related antibiotics.
Renal impairment, renal failure or Clcr <49 mL/min; seizures; history of GI disease, colitis, diarrhea; older adults; PKU; pregnancy (category B).
Route & Dosage
|Upper & Lower Respiratory Tract Infections
Adult: PO 200400 mg q12h taken 1 h a.c. or 2 h p.c.
Child: PO 1530 mg/kg/d divided q12h taken 1 h a.c. or 2 h p.c.
Skin & Skin Structure Infections
Adult: PO 200 mg q12h taken 1 h a.c. or 2 h p.c.
Child: PO 15 mg/kg/d divided q12h taken 1 h a.c. or 2 h p.c.
Urinary Tract Infections
Adult: PO 200 mg q24h or 400 mg q12h taken 1 h a.c. or 2 h p.c.
Child: PO 30 mg/kg/d divided q12h taken 1 h a.c. or 2 h p.c.
Clcr 1049 mL/min: reduce recommended dose by 50% or give standard dose q24h; <10 mL/min: extend dosing interval to
every 35 d
- Reconstitute suspension by adding 30 or 60 mL of water to the 50- or 100-mL bottles, respectively, of dry mixture. Add the
water in 2 portions and shake bottle after each portion.
- Give at least 1 h before or 2 h after meals.
- Give half of the normal dose if Clcr lies between 10 and 49 mL/min.
- Store suspension in a tightly closed container. Discard after 14 d.
Adverse Effects (≥1%)CNS:
Nausea, vomiting, diarrhea, diaper rash, abdominal pain. Other:
May have prolonged bleeding time with warfarin.
Readily absorbed from GI tract. Peak:
4560 min. Distribution:
Distributes into middle ear fluid. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Take a careful history to determine previous hypersensitivity reaction to beta-lactam antibiotics (penicillins and cephalosporins)
or to other allergens.
- Discontinue drug and notify the physician immediately if allergic reaction occurs (e.g., hives, wheezing, rash, pruritus).
- Inspect patient's mouth on a regular basis to detect superinfection (see Appendix F).
- Rule out pseudomembranous enterocolitis (see Appendix F) if severe diarrhea accompanied by abdominal pain and fever occurs.
Notify physician immediately.
- Monitor kidney function throughout therapy with concurrent diuretic use.
Patient & Family Education
- Notify physician immediately of rash or any other allergic reaction.
- Report loose stools or diarrhea promptly.