cefaclor monohydrate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
cefaclor monohydrate: clinical details
Prescribing considerations
- Confirm a bacterial indication and likely susceptibility; cefaclor is inactive against organisms including Pseudomonas, Acinetobacter, methicillin-resistant staphylococci and most enterococci.
- Establish previous reactions to cephalosporins, penicillins and other beta-lactams.
- Use caution with previous colitis, marked renal impairment, central nervous system disorders and increased risk of cephalosporin neurotoxicity.
- Consider formulation-specific indications, administration requirements and excipients.
Contraindications and cautions
- Hypersensitivity to cefaclor, another cephalosporin or a formulation excipient.
- Cefaclor suspensions contain sucrose and should not be used in specified rare hereditary disorders of fructose or sugar handling.
Monitoring
- Assess severe or persistent diarrhoea for antibiotic-associated colitis, including after treatment.
- Monitor clinically and consider laboratory assessment in marked renal impairment or suspected neurotoxicity.
- Consider prothrombin-time or INR monitoring with warfarin.
- Watch for superinfection during prolonged exposure.
- Be aware of possible positive direct Coombs tests and false-positive urine glucose results with some copper-reduction methods.
Clinical pharmacology
Cefaclor is an orally absorbed second-generation cephalosporin. Food delays and lowers the immediate-release peak without changing total absorption, while prolonged-release absorption is enhanced by food. Much of the absorbed medicine is excreted unchanged in urine.
Formulation and product differences
- Granules are reconstituted as a sucrose-containing suspension requiring refrigeration after preparation.
- Capsules and suspension are immediate-release and may be taken with or without food.
- Prolonged-release tablets must be taken with meals and not divided, crushed or chewed.
- Licensed infection types and age suitability are not identical across formulations.
cefaclor monohydrate preparations and strengths
Capsule
Route: Oral
Strengths: 500 mg
Oral suspension
Route: Oral
Strengths: 125 mg/5 mL, 250 mg/5 mL
cefaclor monohydrate interactions
Tell the prescriber or pharmacist about prescription, non-prescription and herbal products. Documented interactions include:
Warfarin
Cefaclor has rarely increased prothrombin time, with or without bleeding; closer anticoagulation monitoring may be required.
Probenecid
It inhibits renal cefaclor excretion and can increase or prolong cefaclor exposure.
Magnesium- or aluminium-containing antacids
Taking these close to a prolonged-release tablet can reduce cefaclor absorption; ask a pharmacist about suitable separation.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.