Cefaclor

Pharmacologic Category

Antibiotic, Cephalosporin (Second Generation)

Dosing: Adult

Treatment of susceptible infections: Oral:

Immediate-release: 250 to 500 mg every 8 hours

Extended-release: 500 mg every 12 hours

Indication-specific dosing: Note: An extended-release tablet dose of 500 mg twice daily is clinically equivalent to an immediate-release capsule dose of 250 mg 3 times daily; an extended-release tablet dose of 500 mg twice daily is NOT clinically equivalent to 500 mg 3 times daily of other cefaclor formulations.

Acute bacterial exacerbations of chronic bronchitis: Oral: Extended-release: 500 mg every 12 hours for 7 days

Secondary bacterial infection of acute bronchitis: Oral: Extended-release: 500 mg every 12 hours for 7 days

* See Dosage and Administration in AHFS Essentials for additional information.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment: Adult

Manufacturer’s labeling:

Oral, immediate-release: There are no dosage adjustments provided in the manufacturer's labeling; however, half-life is increased in anuric patients; use with caution.

Oral, extended-release: There are no dosage adjustments provided in the manufacturer’s labeling.

Dialysis: Moderately dialyzable (20% to 50%)

Alternative recommendations (off-label dosing) (Aronoff 2007):

Oral, immediate-release:

Mild to severe impairment: No dosage adjustment necessary.

End-stage renal disease (ESRD) on intermittent hemodialysis (IHD) (administer after hemodialysis on dialysis days): Supplement with 250 to 500 mg after dialysis.

Peritoneal dialysis: Administer 250 to 500 mg every 8 hours.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Pediatric

General dosing, susceptible infection: Mild to moderate infection: Infants, Children, and Adolescents: Oral, immediate release: 20 to 40 mg/kg/day divided every 8 to 12 hours. Maximum daily dose: 1,500 mg/day (Red Book [AAP 2015])

Bronchitis: Adolescents ≥16 years: Extended release tablet: Note: An extended release tablet dose of 500 mg twice daily is clinically equivalent to an immediate release capsule dose of 250 mg 3 times daily; an extended release tablet dose of 500 mg twice daily is NOT clinically equivalent to 500 mg 3 times daily of other cefaclor formulations.

Acute bacterial exacerbations of chronic bronchitis: Oral: Extended release: 500 mg every 12 hours for 7 days

Secondary bacterial infection of acute bronchitis: Oral: Extended release: 500 mg every 12 hours for 7 days

Lower respiratory tract infections: Infants, Children, and Adolescents: Oral immediate release: 20 to 40 mg/kg/day divided every 8 hours; maximum daily dose: 1,000 mg/day. If beta-hemolytic streptococcus/S. pyogenes suspected, treat for at least 10 days.

Otitis media: Infants, Children, and Adolescents: Oral immediate release: 40 mg/kg/day divided every 8 to 12 hours (oral suspension) or every 8 hours (capsule); maximum daily dose: 1,000 mg/day. If beta-hemolytic streptococcus/S. pyogenes suspected, treat for at least 10 days. Note: Cefaclor is not a recommended treatment option in the AAP guidelines (Lieberthal 2013).

Pharyngitis/tonsillitis: Infants, Children, and Adolescents: Oral immediate release: 20 mg/kg/day divided every 8 to 12 hours (oral suspension) or every 8 hours (capsule); maximum daily dose: 1,000 mg/day. If beta-hemolytic streptococcus/S. pyogenes confirmed, treat for at least 10 days. Note: Cefaclor is not a recommended treatment option in the IDSA guidelines and is not considered preferred by the AHA due to its broad spectrum (AHA [Gerber 2009], IDSA [Shulman 2012]).

Skin and skin structure infections, uncomplicated: Infants, Children, and Adolescents: Oral: Immediate release: 20 to 40 mg/kg/day divided every 8 hours; maximum daily dose: 1,000 mg/day. If due to beta-hemolytic streptococcus/S. pyogenes, treat for at least 10 days.

Urinary tract infections: Infants, Children, and Adolescents: Oral: Immediate release: 20 to 40 mg/kg/day divided every 8 hours; maximum daily dose: 1,000 mg/day

Dosing: Renal Impairment: Pediatric

Manufacturer's labeling:

Oral, immediate release: Infants, Children, and Adolescents: There are no dosage adjustments provided in the manufacturer's labeling; however, half-life is increased in anuric patients; use with caution.

Oral, extended release: There are no dosage adjustments provided in the manufacturer's labeling.

Alternative recommendations (Aronoff 2007): Dosing based on usual dose of 20 to 40 mg/kg/day in divided doses every 8 to 12 hours

Infants, Children, and Adolescents: Oral, immediate release:

GFR ≥10 mL/minute/1.73 m²: No dosage adjustment necessary.

GFR <10 mL/minute/1.73 m²: Administer 50% of the recommended dose.

End-stage renal disease (ERD) on intermittent hemodialysis (IHD) (supplemental dose posthemodialysis needed): Administer 50% of the recommended dose.

Peritoneal dialysis: Administer 50% of the recommended dose.

Hemodialysis: Hemodialysis shortens half-life by 25% to 35%

Moderately dialyzable (20% to 50%) (Aronoff 2007)

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Calculations

Use: Labeled Indications

Acute bacterial exacerbations of chronic bronchitis (extended-release tablets only): Treatment of acute bacterial exacerbations of chronic bronchitis due to Haemophilus influenzae (excluding beta-lactamase-negative, ampicillin-resistant strains only), Moraxella catarrhalis, or Streptococcus pneumoniae.

Lower respiratory tract infections (capsules and oral suspension only): Treatment of lower respiratory tract infections, including pneumonia, caused by S. pneumoniae, H. influenzae, and Streptococcus pyogenes.

Otitis media (capsules and oral suspension only): Treatment of otitis media caused by S. pneumoniae, H. influenzae, staphylococci, and S. pyogenes.

Pharyngitis and tonsillitis: Treatment of pharyngitis and tonsillitis due to S. pyogenes.

Secondary bacterial infections of acute bronchitis (extended-release tablets only): Treatment of secondary bacterial infections of acute bronchitis due to H. influenzae (excluding beta-lactamase negative, ampicillin-resistant strains), M. catarrhalis, or S. pneumoniae.

Skin and skin structure infections, uncomplicated: Treatment of uncomplicated skin and skin structure infections due to Staphylococcus aureus (methicillin-susceptible) or S. pyogenes (capsules and oral suspension only).

Urinary tract infections (capsules and oral suspension only): Treatment of urinary tract infections, including pyelonephritis and cystitis, caused by Escherichia coli, Proteus mirabilis, Klebsiella spp, and coagulase-negative staphylococci.

* See Uses in AHFS Essentials for additional information.

Class and Related Monographs

Cephalosporins

Clinical Practice Guidelines

Pharyngitis, Group A Streptococci:

IDSA, “Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis,” September 2012

Urinary Tract Infections:

IDSA, “International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women,” March 2011

Administration: Oral

Administer around-the-clock to promote less variation in peak and trough serum levels.

Capsules and oral suspension: Administer without regard to meals; shake oral suspension well before using.

Extended release tablets: Do not chew, crush, or split; administer with or within 1 hour of food.

Administration: Pediatric

Oral: Administer around-the-clock to promote less variation in peak and trough serum levels.

Capsules and oral suspension: Administer without regard to meals; shake oral suspension well before using.

Extended release tablets: Do not chew, crush, or split; administer with or within 1 hour of food.

Dietary Considerations

Extended release tablets should be taken with or within 1 hour of food.

Storage/Stability

Store at 20°C to 25°C (68°F to 77°F). Refrigerate suspension after reconstitution and discard after 14 days.

Preparation for Administration: Adult

Oral suspension: Refer to manufacturer’s product labeling for reconstitution instructions. Shake well.

Preparation for Administration: Pediatric

Oral suspension: Refer to manufacturer's product labeling for reconstitution instructions.

Medication Patient Education with HCAHPS Considerations

What is this drug used for?

• It is used to treat bacterial infections.

Frequently reported side effects of this drug

• Diarrhea

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

• Bruising

• Bleeding

• Seizures

• Chills

• Sore throat

• Severe loss of strength and energy

• Severe dizziness

• Passing out

• Burning or numbness feeling

• Unable to pass urine

• Change in amount of urine passed

• Vaginal pain, itching, or discharge

• Clostridioides (formerly Clostridium) difficile-associated diarrhea like abdominal pain or cramps, severe diarrhea or watery stools, or bloody stools

• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Medication Safety Issues

Sound-alike/look-alike issues:

Contraindications

Hypersensitivity to cefaclor, any component of the formulation, or other cephalosporins

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity: Anaphylactic reactions have occurred. If a serious hypersensitivity reaction occurs, discontinue and institute emergency supportive measures, including airway management and treatment (eg, epinephrine, antihistamines, and/or corticosteroids).

• Penicillin allergy: Use with caution in patients with a history of penicillin allergy.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.

Disease-related concerns:

• Gastrointestinal disease: Use with caution in patients with a history of gastrointestinal disease, particularly colitis.

• H. influenzae infections: Beta-lactamase-negative, ampicillin-resistant (BLNAR) strains of H. influenzae should be considered resistant to cefaclor.

• Renal impairment: Use with caution in patients with renal impairment.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC, 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors, 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer’s labeling.

• Extended-release tablet: An extended-release tablet dose of 500 mg twice daily is clinically equivalent to an immediate-release capsule dose of 250 mg 3 times daily; an extended-release tablet dose of 500 mg twice daily is NOT clinically equivalent to 500 mg 3 times daily of other cefaclor formulations.

* See Cautions in AHFS Essentials for additional information.

Geriatric Considerations

Has not been studied in the elderly. Adjust dose for renal function in elderly. Considered to be one of the drugs of choice in the outpatient treatment of community-acquired pneumonia in elderly.

Warnings: Additional Pediatric Considerations

May cause serum sickness-like reaction (estimated incidence ranges from 0.024% to 0.2% per drug course); majority of reactions have occurred in children <5 years of age with symptoms of fever, rash, erythema multiforme, and arthralgia, often occurring during the second or third exposure.

Pregnancy Risk Factor

Pregnancy Considerations

Adverse events were not observed in animal reproduction studies. An increased risk of teratogenic effects has not been observed following maternal use of cefaclor.

Breast-Feeding Considerations

Small amounts of cefaclor are excreted in breast milk. The manufacturer recommends that caution be exercised when administering cefaclor to nursing women. Nondose-related effects could include modification of bowel flora.

Lexicomp Pregnancy & Lactation, In-Depth

Cefaclor

Briggs' Drugs in Pregnancy & Lactation

Cefaclor

Adverse Reactions

1% to 10%:

Dermatologic: Rash (1% to 2%; includes erythematous rash, maculopapular rash, or morbilliform rash)

Gastrointestinal: Diarrhea (3%)

Genitourinary: Vaginitis (2%), vulvovaginal candidiasis (2%)

Hematologic & oncologic: Eosinophilia (2%)

Hepatic: Increased serum transaminases (3%)

<1%, postmarketing, and/or case reports: Agitation, agranulocytosis, anaphylaxis, angioedema, aplastic anemia, arthralgia, cholestatic jaundice, confusion, dizziness, drowsiness, hallucination, hemolytic anemia, hepatitis, hyperactivity, insomnia, interstitial nephritis, irritability, nausea, nervousness, neutropenia, paresthesia, prolonged prothrombin time, pruritus, pseudomembranous colitis, seizure, serum sickness, Stevens-Johnson syndrome, thrombocytopenia, toxic epidermal necrolysis, urticaria, vomiting

* See Cautions in AHFS Essentials for additional information.

Allergy and Idiosyncratic Reactions

Cephalosporin Allergy

Metabolism/Transport Effects

Substrate of OAT1/3

Drug Interactions Open Interactions

Aminoglycosides: Cephalosporins (2nd Generation) may enhance the nephrotoxic effect of Aminoglycosides. Risk C: Monitor therapy

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Risk C: Monitor therapy

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid combination

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Risk C: Monitor therapy

Nitisinone: May increase the serum concentration of OAT1/3 Substrates. Risk C: Monitor therapy

Pretomanid: May increase the serum concentration of OAT1/3 Substrates. Risk C: Monitor therapy

Probenecid: May increase the serum concentration of Cephalosporins. Risk C: Monitor therapy

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider therapy modification

Teriflunomide: May increase the serum concentration of OAT1/3 Substrates. Risk C: Monitor therapy

Tolvaptan: May increase the serum concentration of OAT1/3 Substrates. Management: Avoid concomitant use of OAT1/3 substrates in patients receiving the Jynarque brand of tolvaptan. Concentrations and effects of the OAT1/3 substrate would be expected to increase with combined use. Risk D: Consider therapy modification

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 3 days after cessation of antibacterial agents. Risk D: Consider therapy modification

Vitamin K Antagonists (eg, warfarin): Cephalosporins may enhance the anticoagulant effect of Vitamin K Antagonists. Risk C: Monitor therapy

Food Interactions

The bioavailability of cefaclor extended-release tablets is decreased 23% and the maximum concentration is decreased 67% when taken on an empty stomach. Management: Administer with food.

Test Interactions

Positive direct Coombs', false-positive urinary glucose test using cupric sulfate (Benedict's solution, Clinitest, Fehling's solution).

Monitoring Parameters

Monitor renal function. Observe for signs of anaphylaxis during first dose.

Advanced Practitioners Physical Assessment/Monitoring

Assess results of culture/sensitivity tests and patient's allergy history prior to therapy. Monitor for nephrotoxicity. Hypersensitivity can occur days after therapy is started. Advise patients with diabetes about use of Clinitest®. Teach patient to report hypersensitivity and opportunistic infection.

Nursing Physical Assessment/Monitoring

Results of culture/sensitivity tests and patient's allergy history should be assessed prior to therapy. Monitor for nephrotoxicity. Hypersensitivity can occur days after therapy is started. Advise patients with diabetes about use of Clinitest®. Teach patient to report hypersensitivity and opportunistic infections.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Generic: 250 mg, 500 mg

Suspension Reconstituted, Oral:

Generic: 125 mg/5 mL (150 mL); 250 mg/5 mL (150 mL); 375 mg/5 mL (100 mL)

Tablet Extended Release 12 Hour, Oral:

Generic: 500 mg

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Generic: 250 mg, 500 mg

Suspension Reconstituted, Oral:

Generic: 125 mg/5 mL ([DSC]); 250 mg/5 mL ([DSC]); 375 mg/5 mL ([DSC])

Anatomic Therapeutic Chemical (ATC) Classification

J01DC04

Generic Available (US)

Yes

Pricing: US

Capsules (Cefaclor Oral)

250 mg (per each): $2.59

500 mg (per each): $5.06

Suspension (reconstituted) (Cefaclor Oral)

125 mg/5 mL (per mL): $4.20

250 mg/5 mL (per mL): $4.62

375 mg/5 mL (per mL): $6.30

Tablet, 12-hour (Cefaclor ER Oral)

500 mg (per each): $21.40

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Mechanism of Action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs), which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Pharmacodynamics/Kinetics

Absorption: Oral: Well absorbed; acid stable

Distribution: Distributes into tissues and fluids including bone, pleural and synovial fluid

Protein binding: 25% (Aronoff 2007)

Half-life elimination: 0.6 to 0.9 hours; prolonged with renal impairment (2.3 to 2.8 hours in anuria)

Time to peak: Capsules, oral suspension: 30 to 60 minutes; Extended-release tablets: 2.5 hours

Excretion: Urine (60% to 85% as unchanged drug)

Dental Use

Alternative antibiotic for treatment of orofacial infections in patients allergic to penicillins; susceptible bacteria including aerobic gram-positive bacteria and anaerobes

* See Uses in AHFS Essentials for additional information.

Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions

Dental Health Professional Considerations

Cefaclor is effective against anaerobic bacteria, but the sensitivity of alpha-hemolytic Streptococcus vary; approximately 10% of strains are resistant. Nearly 70% are intermediately sensitive. Patients allergic to penicillins can use a cephalosporin; the incidence of cross-reactivity between penicillins and cephalosporins is 1% to 5% when the allergic reaction to penicillin is delayed. If the patient has a history of anaphylaxis to penicillin, cephalosporins are contraindicated in these patients.

Effects on Dental Treatment

No significant effects or complications reported (see Dental Health Professional Considerations)

Effects on Bleeding

No information available to require special precautions

Dental Usual Dosing

Orofacial infections: Adults: Oral: Dosing range: 250-500 mg every 8 hours

Related Information

Oral Medications That Should Not Be Crushed or Altered

Index Terms

Ceclor; Raniclor

FDA Approval Date

April 04, 1979

References

Ahlfors CE. Benzyl alcohol, kernicterus, and unbound bilirubin. J Pediatr. 2001;139(2):317-319.[PubMed 11487763]

American Thoracic Society, “Guidelines for the Initial Management of Adults With Community-Acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy,” Am Rev Respir Dis, 1993, 148(5):1418-26.[PubMed 8239186]

Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007, p 61, 153.

Boguniewicz M and Leung DYM, “Hypersensitivity Reactions to Antibiotics Commonly Used in Children,” Pediatr Infect Dis J, 1995, 14(3):221-31.[PubMed 7761188]

Campagna JD, Bond MC, Schabelman E, Hayes BD. The use of cephalosporins in penicillin-allergic patients: a literature review. J Emerg Med. 2012; 42(5):612-620.[PubMed 21742459]

Cefaclor Capsules [prescribing information]. Eatontown, NJ: West-Ward Pharmaceuticals; July 2015.

Cefaclor Extended-Release Tablets [prescribing information]. North Wales, PA: Teva Pharmaceuticals; December 2014.

Cefaclor for Oral Suspension [prescribing information]. Research Triangle Park, NC: Cerecor Inc; February 2018.

Centers for Disease Control (CDC). Neonatal deaths associated with use of benzyl alcohol—United States. MMWR Morb Mortal Wkly Rep. 1982;31(22):290-291. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001109.htm [PubMed 6810084]

Donowitz GR and Mandell GL, “Beta-Lactam Antibiotics,” N Engl J Med, 1988, 318(7):419-26 and 318(8):490-500.[PubMed 3277054]

Gerber MA, Baltimore RS, Eaton CB, et al. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation. 2009;119(11):1541-1551.[PubMed 19246689 ]

Hyslop DL, “Cefaclor Safety Profile: A Ten Year Review,” Clin Ther, 1988, 11(Suppl A):83-94.[PubMed 3242837]

"Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics (AAP) Committee on Drugs. Pediatrics. 1997;99(2):268-278.[PubMed 9024461]

Levine LR, “Quantitative Comparison of Adverse Reactions to Cefaclor vs Amoxicillin in a Surveillance Study,” Pediatr Infect Dis, 1985, 4(4):358-61.[PubMed 3161007]

Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013;131(3):e964-999.

Marshall WF and Blair JE, “The Cephalosporins,” Mayo Clin Proc, 1999, 74(2):187-95.[PubMed 10069359]

Saxon A, Beall GN, Rohr AS, et al, “Immediate Hypersensitivity Reactions to Beta-Lactam Antibiotics,” Ann Intern Med, 1987, 107(2):204-15.[PubMed 3300459]

Shulman ST, Bisno AL, Clegg HW, et al; Infectious Diseases Society of America. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-102.[PubMed 22965026]

Smith GH, “Oral Cephalosporins in Perspective,” DICP, 1990, 24(1):45-51.[PubMed 2405586]

Terico AT, Gallagher JC. Beta-lactams hypersensitivity and cross-reactivity. J Pharm Pract. 2014;27(6):530-544.[PubMed 25124380]

Wright AJ, “The Penicillins,” Mayo Clin Proc, 1999, 74(3):290-307.[PubMed 10090000]

Brand Names: International

Abaclor (BD); Ackfa (LK); Aclor (AU); Alclor (BD); Alfatil (FR); Alfatil LP (FR); Bacticlor (EG); Bearclor (VN); Beinuoke (CN); Bioclocel (PH); CEC (AT, BG, DO); Cec (MX); CEC 500 (DE); Ceclobid (PH); Ceclodyne (RO); Ceclor (AE, AT, AU, BB, BF, BJ, BM, BR, BS, BZ, CH, CI, CN, CO, EC, EG, ES, ET, GH, GM, GN, GR, GY, HK, HN, HU, JM, JO, KE, KR, LB, LR, MA, ML, MR, MU, MW, MX, NE, NG, NL, PE, PH, PK, PL, PT, QA, RO, RU, SA, SC, SD, SL, SN, SR, TN, TR, TT, TZ, UG, VE, ZM); Ceclor AF (PE); Ceclor CD (AU); Ceclor DS (PH); Ceclor MR (BF, BJ, CI, CY, ET, GH, GM, GN, HK, KE, KW, LB, LR, MA, ML, MR, MU, MW, NE, NG, SA, SC, SD, SL, SN, TN, TZ, UG, ZM); Ceclor PDR (CY); Ceclor Retard (CH); Cecrun (KR); Cefabac (AE, CY, IL, IQ, IR, JO, LB, LY, OM, SA, SY, YE); Cefacle (KR); Cefacloren (BR); Cefaloc (PH); Cefclor (TH); Ceflacid (MX); Cefmed (PH); Cektin (KR); Celormed (VN); Cephlor (AE, CY, IL, IQ, IR, LB, LY, OM, SA, SY, YE); Ceracl (KR); Cero (TW); Cevacl (KR); Cleancef (SG, VN); Clex (KR); Clocef (BD); Cloracef (BH, ID, JO, QA); Cloracef MR (AE, CY, IL, IQ, IR, JO, KW, LB, LY, OM, SA, SY, YE); Clorcef (PH); Distaclor (CO, GB, IE, MY, SG, TH); Dorocor (VN); Efaclor (MY); Eurocefix (MT); Forbatec (AE, CY, IL, IQ, IR, LB, LY, OM, SA, SY, YE); Forifek (ID); Forticef (JO); Haxifal (FR); Karlor CD (AU); Kefaclor (TZ); Keflor (AU, IN); Keflor CD (AU); Kefolor (FI); Keftid (GB); Kemocin (KR); Kerfenmycin (TW); Lanaclor (EG); Locef (NZ); Lorcef (PH); Medacef (AE, KW, QA, SA); Medoclor (BG, HK, TR); Metiny (VN); Miclor (KR); Midocef (JO); Panacef (IT); Panoral (DE); Panoral Forte (DE); Pharmaclor (AE, CY, IL, IQ, IR, LB, LY, OM, SA, SY, YE); Pinaclor (IE); Qualiceclor (HK); Qualiphor (HK); Ranclor (MX); Sefaclor (MY); Seporin (KR); Serviclor (MX); Sifaclor (TH); Soclor (ID); Soficlor (HK, MY); Surecef (PH); Swiflor (TW); U-Clor (TW); Vefarol (PH); Vercaf (ZW); Vercef (AE, BF, BH, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, MY, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZA, ZM); Vercef MR (ZW); Versef (PH); Wonclor (KR); Xelent (PH); Xeztron (PH); Zaike (CN)

Last Updated 3/11/20

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