Cefaclor Dosage

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Usual Adult Dose for Bronchitis

Acute bacterial exacerbation of chronic bronchitis or secondary bacterial infection of acute bronchitis:
Immediate-release: 250 to 500 mg orally every 8 hours
Extended-release: 500 mg orally every 12 hours with food
Duration: 7 days

Usual Adult Dose for Otitis Media

Immediate-release: 250 to 500 mg orally every 8 hours for 10 to 14 days

Usual Adult Dose for Pneumonia

Mild to moderate:
Immediate-release: 500 mg orally every 8 hours for 10 to 21 days

Usual Adult Dose for Pyelonephritis

Mild to moderate:
Immediate-release: 500 mg orally every 8 hours for 14 days

Usual Adult Dose for Sinusitis

Immediate-release: 250 to 500 mg orally every 8 hours for 10 to 14 days
Extended-release: 375 mg orally every 12 hours with food
Duration: 10 to 14 days. Longer courses of therapy, sometimes 3 to 4 weeks, may be required for refractory or recurrent cases.

Usual Adult Dose for Skin or Soft Tissue Infection

Uncomplicated:
Immediate-release: 250 to 500 mg orally every 8 hours
Extended-release: 375 mg orally every 12 hours with food
Duration: 7 to 10 days

Usual Adult Dose for Tonsillitis/Pharyngitis

Immediate-release: 250 to 500 mg orally every 8 hours
Extended-release: 375 mg orally every 12 hours with food
Duration: 10 days

Usual Adult Dose for Upper Respiratory Tract Infection

Mild to moderate:
Immediate-release: 250 to 500 mg orally every 8 hours for 10 days
Extended-release: 375 mg orally every 12 hours with food
Duration: 10 days

Usual Adult Dose for Urinary Tract Infection

Immediate-release: 250 to 500 mg orally every 8 hours for 3 to 10 days

Usual Pediatric Dose for Otitis Media

1 month or older:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day
Duration: At least 10 days

Usual Pediatric Dose for Tonsillitis/Pharyngitis

1 month or older:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day
Duration: At least 10 days

Usual Pediatric Dose for Cystitis

1 month or more:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day

Usual Pediatric Dose for Pneumonia

1 month or more:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day

Usual Pediatric Dose for Pyelonephritis

1 month or more:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day

Usual Pediatric Dose for Urinary Tract Infection

1 month or more:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day

Usual Pediatric Dose for Skin and Structure Infection

1 month or more:
Immediate-release: 20 to 40 mg/kg/day orally in divided doses every 8 or 12 hours; do not exceed 1 g/day

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Precautions

Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following cephalosporin therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.

Cephalosporins may be associated with a fall in prothrombin activity. Risk factors include renal or hepatic impairment, poor nutritional state, a protracted course of antimicrobial therapy, and chronic anticoagulation therapy. Prothrombin times should be monitored and vitamin K therapy initiated if indicated.

Serious and occasionally fatal hypersensitivity reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of a skin rash or other signs of hypersensitivity. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.

Caution is recommended in patients with significant renal impairment and monitoring is recommended. Some cephalosporins have been associated with seizures in renally impaired patients with elevated serum concentrations. The drug should be discontinued if seizures occur.

Patients with phenylketonuria should be aware that some formulations (e.g., chewable tablets) contain phenylalanine.

Aluminum- or magnesium-containing antacids should not be given within 1 hour of extended-release cefaclor tablets.

Efficacy of the extended-release formulation has not been established for the treatment of skin and soft tissue infections due to Streptococcus pyogenes.

Safety and efficacy of the extended release formulation have not been established in children less than 18 years.

Dialysis

Cefaclor is moderately dialyzable (20% to 30% reduction in half-life).

Other Comments

Cefaclor should be administered for at least 10 days when treating beta-hemolytic streptococcal infections.

The absorption of cefaclor extended-release is enhanced when it is administered with food.

Cefaclor chewable tablets should be chewed before swallowing.

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