cefaclor
Fuentes regulatorias consultadas
Indicaciones aprobadas
- Exacerbación bacteriana aguda de bronquitis crónica, faringitis/amigdalitis e infecciones no complicadas de piel por microorganismos sensibles.
Contraindicaciones
Absolutas
- Hipersensibilidad a cefaclor o cefalosporinas, o antecedente de reacción inmediata y grave a otro betalactámico.
Advertencias clínicas
- Advertencia mayor · Puede causar hipersensibilidad grave o anafilaxia. Antes de administrarlo, revisa antecedentes de reacción inmediata a betalactámicos y suspende si aparece una reacción alérgica. — FDA, set_id 0878bdc2-0410-4938-9890-96523aa81c2f
- Advertencia mayor · Puede producir diarrea asociada a Clostridioides difficile durante o después del tratamiento; evalúa diarrea importante y evita antiperistálticos si se sospecha colitis. — FDA, set_id 0878bdc2-0410-4938-9890-96523aa81c2f
Interacciones medicamentosas
- SeveraAnticoagulantes orales
Mecanismo: El antibiótico y la infección pueden aumentar el INR o el riesgo de sangrado.
Recomendación: Controla INR y signos de sangrado durante y poco después del tratamiento.
FDA, set_id 0878bdc2-0410-4938-9890-96523aa81c2f
- ModeradaProbenecid
Mecanismo: Reduce la secreción tubular renal y puede aumentar y prolongar la exposición al antibiótico.
Recomendación: Evita la combinación salvo indicación deliberada y vigila toxicidad.
FDA, set_id 0878bdc2-0410-4938-9890-96523aa81c2f
- ModeradaAntiácidos con hidróxido de magnesio o aluminio
Mecanismo: Reducen la absorción de cefaclor de liberación prolongada si se administran dentro de una hora.
Recomendación: Separa la administración al menos una hora.
FDA, set_id 0878bdc2-0410-4938-9890-96523aa81c2f
Eventos adversos
Comunes (≥1%)
Náuseas, diarrea y erupción cutánea
Raros pero graves
Anafilaxia, colitis por C. difficile y citopenias graves
Embarazo y lactancia
Usar durante el embarazo solo cuando esté claramente indicado. Pasa a la leche en pequeñas cantidades; vigila diarrea, candidiasis o sensibilización en el lactante y valora la continuidad según el producto.
Bibliografía reciente (PubMed)
This study systematically evaluated and ranked the efficacy of first- and second-line antibiotics antibiotic options for the clinical management of cellulitis and erysipelas through a network meta-analysis approach. From inception to July 04, 2024, a search for relevant randomized clinical trials (RCTs) was carried out using several databases. Antibiotics including azithromycin, cefaclor, cephalexin, cloxacillin, erythromycin, cephalexin plus trimethoprim-sulfamethoxazole, cephalexin plus placebo, flucloxacillin, clindamycin, ceftriaxone, penicillin, roxithromycin, and pristinamycin were assessed regarding cure rate, the eradication of baseline pathogens, diarrhea or vomiting, and rash. In total, 10 RCTs with 1,936 cellulitis or erysipelas patients were eligible for inclusion. There were no significant differences in the cure rates for cellulitis among the antibiotics analysed, with cefaclor demonstrating the most favorable profile for curative outcomes. In terms of side effects, ceftriaxone was identified as the least likely to induce diarrhea or vomiting. For erysipelas, pristinamycin showed the most promising results in achieving cure rates. Although a comparison of the three antibiotics revealed no significant differences in rash as a side effect in erysipelas, pristinamycin was observed to carry the highest risk for rash. Our findings indicate no significant differences in cure rates among antibiotics for cellulitis. However, ceftriaxone had the fewest gastrointestinal side effects. Pristinamycin showed the highest cure rates for erysipelas but with a higher risk of rash. Future research should focus on optimizing antibiotic selection for cellulitis and erysipelas.
Copper (Cu) is an essential trace metal and its concentration in body plasma is tightly regulated. An increase in Cu concentration in body fluids is observed in numerous pathological conditions, including infections caused by microorganisms. Evidence shows that Cu ions can impact the activity of antibiotics by increasing efficiency or diminishing/neutralizing antibiotic activity, forming complexes which may lead to antibiotic structure degradation. Herein, we represent the evidence available on Cu-antibiotic interactions and their possible impact on antimicrobial therapy efficiency. So far, in vitro studies described interactions between Cu ions and the majority of antibiotics in clinical use: penicillins, cephalosporins, carbapenems, macrolides, aminoglycosides, tetracyclines, fluoroquinolones, isoniazid, metronidazole. In vitro-described degradation or lower antimicrobial activity of amoxicillin, ampicillin, cefaclor, ceftriaxone, and meropenem in the presence of Cu ions suggest caution when using prescribed antibiotics in patients with altered Cu levels. On the other hand, several Cu-dependent compounds with antibacterial activity including the drug-resistant bacteria were discovered, such as thiosemicarbazones, disulfiram, dithiocarbamates, 8-hydroxiquinoline, phenanthrolines, pyrithione. Having in mind that the development of new antibiotics is already marked as inadequate and does not meet global needs, the potential of Cu-antibiotic interactions to change the efficiency of antimicrobial therapy requires further investigation.
Cefaclor is a bactericidal antibiotic recommended for treating diverse types of infections. This review aims to comprehensively assess the pharmacokinetic (PK) data on cefaclor in humans.Google Scholar, PubMed, Cochrane Library, and EBSCO databases were systematically performed to identify all the relevant studies containing at least one reported PK parameter of cefaclor.Cefaclor shows the linear PK profile as the area under the plasma concentration-time curve from 0 to t (AUC0-t) and maximum plasma concentration (Cmax) increase in a dose-dependent manner. The AUC0-t of cefaclor in the rice diet was found to be higher than that of bread food, i.e. 19.9 ± 2.6 ug/ml.hr vs 15.4 ± 4 ug/ml.hr. The AUC in paediatrics during the fed state was significantly higher compared to that in adults. Patients with renal impairments showed a Cmax 2.2 times higher than that of normal subjects. A significant increase in Cmax was depicted among individuals following a vegetarian diet in comparison with the non-vegetarian diet. Moreover, cefaclor exhibits time-dependent killing above the minimum inhibitory concentration (MIC < 2 ug), favouring its use in treating infections caused by specific pathogens.This systematic review summarises all the reported PK parameters of cefaclor in healthy and diseased subjects in the literature. This data can help practitioners in adjusting cefaclor doses among different diseases and populations to avoid drug interactions and adverse effects.