Cefaclor
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Trade Name
Ceclor (historical brand name, discontinued in some regions); generic cefaclor
Classification
Second-generation cephalosporin antibiotic; beta-lactam
Dosage/Route
- * Dosage:
- – Capsules: 250 mg, 500 mg
- – Suspension: 125 mg/5 mL, 187 mg/5 mL, 250 mg/5 mL, 375 mg/5 mL
- * Route: Oral (PO)
Usual Dosage
- * Adults: 250-500 mg PO every 8 hours (TID); max 4 g/day
- * Children: 20-40 mg/kg/day PO divided TID; max 1 g/day
- * Severe Infections: May increase to 40 mg/kg/day in kids or 500 mg TID in adults
- * Duration: 7-10 days (e.g., 10 days for strep throat)
Mechanism of Action
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, disrupting peptidoglycan cross-linking. Bactericidal against gram-positive (e.g., Streptococcus) and some gram-negative bacteria (e.g., H. influenzae, E. coli); broader spectrum than first-generation cephalosporins
Side Effects & Adverse Effects
- * Side Effects: Diarrhea, nausea, rash, headache
- * Adverse Effects:
- – Hypersensitivity (rash, anaphylaxis; cross-reactivity with penicillin allergy ~5-10%)
- – Clostridioides difficile-associated diarrhea (CDAD)
- – Serum sickness-like reaction (rare; rash, joint pain, fever)
- – Rare: Hematologic (e.g., neutropenia)
Nursing Management (Implications & Teachings)
- * Implications:
- – Assess for penicillin/cephalosporin allergy (anaphylaxis risk) before first dose
- – Monitor GI symptoms (diarrhea = CDAD) and rash (hypersensitivity)
- – Culture/sensitivity if possible before starting (confirm susceptibility)
- – Give with food if GI upset occurs (unlike some antibiotics)
- * Teachings:
- – Finish full course; don’t skip doses
- – Report hives, swelling, or severe diarrhea
- – Shake suspension well; store in fridge (stable 14 days)
- – Take evenly spaced (e.g., 8 AM, 4 PM, midnight)
Indication for This Patient
* Bacterial infections:
- – Respiratory (e.g., pneumonia, sinusitis, bronchitis)
- – Otitis media (H. influenzae, S. pneumoniae)
- – Skin infections, UTI (susceptible organisms
Time
- * Timing: Every 8 hours (TID)
- * Onset: Symptom relief in 1-3 days
- * Duration: 7-10 days (infection-specific)
