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Drug dosage identifier

Cefaclor

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Dose and administration

  1. 10mg/kg/day PO nocte prophylaxis.
  2. 10mg/kg/DOSE 3 times a day as treatment

Indications

  1. Prophylaxis against urinary tract infections.
  2. Treatment e.g. otitis media.

Contraindications and precautions

Hypersensitivity to penicillin or cephalosporins.

Clinical pharmacology

Semisynthetic second generation cephalosporin antibiotic for oral administration. Usually active against the following organisms: Staphylococci species, Streptococcus pyogenes, Streptococcus pneumoniae, Escherichia coli, Proteus spp, Klebsiella spp, Haemophilus influenzae (including most beta lactamase producing ampicillin resistant strains), Neisseria gonorrhoeae, and several anaerobic bacteria (excluding Bacteroides fragilis). Note that Pseudomonas spp and most strains of enterococci, enterobacter spp, indole positive proteus and serratia spp are resistant to cefaclor. Action results from inhibition of synthesis of cell wall mucopeptides.

Cefaclor is well absorbed after oral administration, whether taken with food or while fasting. However, when taken with food, the peak concentration is less and occurs later than that observed when the medicine is administered to fasting subjects. Widely distributed throughout body fluids and tissues. Does not penetrate the CSF. Approximately 60-85% of the drug is excreted unchanged in the urine. Elevated serum concentrations may be reduced by haemodialysis.

Possible adverse effects

  • Rash, fever and urticaria.
  • Gastrointestinal disturbances (nausea, vomiting, diarrhoea, candidiasis).
  • Transient fluctuations in leucocyte count, eosinophilia, thrombocytopenia.
  • False/positive Coomb's test, 40-75%.
  • Transient slight elevations in AST, ALP, or serum creatinine.
  • Stevens-Johnson Syndrome, toxic epidermal necrolysis.
  • Hyperactivity, somnolence.
  • False/positive urine glucose determination on Clinitest.

Interactions

Chloramphenicol - antagonistic effect do not use together.

Special considerations

  1. The safety and effectiveness of cefaclor for use in infants less than one month of age has not been established.
  2. False/positive reaction for glucose in the urine may occur with Clinitest tablets.

Management of Cefaclor administration

Description

Pink powder for reconstitution to a suspension pink coloured, strawberry flavoured 25 mg/ml.

Prescription

Charted on prescription chart in mg/dose.

Administration

  1. Reconstitute with water. Add 60ml of water in 2 portions to the dry mixture in the bottle. Shake well after each addition.
  2. Shake well before use.
  3. Can be administered independent of food.

Nursing considerations

  1. Observe for signs of adverse effects.
  2. Monitor for signs of super infection.

Storage

  • At room temperature <30°C until reconstituted.
  • Reconstituted solution: store in refrigerator up to 14 days.

References

  1. Prescribing information (product disclosure), Eli Lilly & Co (NZ) Ltd.
  2. Nursing 97 Drug Handbook Springhouse 1997, p106-7.
  3. Royal Children's Hospital, Melbourne. Paediatric Pharmacopoeia 11th Edition 1994 p27.

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Document Control

  • Date last published: 28 February 2018
  • Document type: Drug Dosage Guideline
  • Services responsible: ADHB Pharmacy, Neonatology
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years