MEDACEF 125MG DRY SUSPENSION

Indications

• Susceptible infections due to sensitive Gram-positive bacteria
• Susceptible infections due to sensitive Gram-negative bacteria
• Respiratory tract infections
• Skin infections
• Urinary tract infections
• Surgical prophylaxis

Dosage

Adults: 500 mg three times a day, maximum 4 g per day. For severe infections

Mechanism of action

Cefaclor, like other beta-lactam antibiotics, binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding inhibits the third and final stage of bacterial cell wall synthesis. The resultant weakening of the cell wall structure leads to cell lysis, which is further mediated by bacterial cell wall autolytic enzymes such as autolysins. Cefaclor may also interfere with an autolysin inhibitor, enhancing its antibacterial effect.

Pharmacodynamics

Cefaclor exhibits bactericidal activity through the inhibition of cell wall synthesis, which is characteristic of cephalosporins. The drug is effective against a broad spectrum of bacteria, including Staphylococci (both coagulase-positive and coagulase-negative strains), Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Haemophilus influenzae, Klebsiella species, and Proteus mirabilis. Its action is confirmed by both in vitro and in vivo studies demonstrating efficacy against most strains of these pathogens.

Pharmacokinetics

Cefaclor is administered orally and is well absorbed from the gastrointestinal tract. It achieves peak plasma concentrations within 1 to 2 hours after administration. The drug is widely distributed in body tissues and fluids, including the lungs, skin, and urine, where it exerts its therapeutic effects. Cefaclor is primarily excreted unchanged in the urine, and its half-life is approximately 0.6 to 1 hour. Dose adjustments may be necessary in patients with renal impairment.

Adverse effects

• Rash
• Nausea
• Diarrhea
• Abdominal pain
• Allergic reactions
• Hepatic dysfunction
• Renal impairment

Interactions

• Leflunomide: Unknown (increases exposure)
• Nitisinone: Unknown (increases exposure)
• Teriflunomide: Unknown (increases exposure)

Precautions

• Use with caution in patients with a history of hypersensitivity to penicillins or cephalosporins
• Monitor renal function in patients with renal impairment
• Consider potential for Clostridium difficile-associated diarrhea

Pregnancy

Not known to be harmful.

Breast-feeding

Present in milk in low concentration, but appropriate to use.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Oral suspension: 125 mg/5 mL
• Capsules: 250 mg, 500 mg
• Powder for solution for injection: 1 g

Mechanism of action

Cefaclor, like the penicillins, is a beta-lactam antibiotic. By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, it inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins. It is possible that cefaclor interferes with an autolysin inhibitor.

Pharmacodynamics

Cefaclor is a second generation cephalosporin antibiotic with a spectrum resembling first-generation cephalosporins. <i>In vitro</i> tests demonstrate that the bactericidal action of the cephalosporins results from inhibition of cell-wall synthesis. As indicated by _in vitro_ and _in vivo_ clinical studies, cefaclor was shown to be effective against most strains of Gram positive aerobes - Staphylococci (including coagulase-positive, coagulase-negative, and penicillinase-producing strains), <i>Streptococcus pneumoniae</i>, <i>Streptococcus pyogenes</i> (group A &szlig;-hemolytic streptococci), as well as Gram-negative aerobes - <i>Escherichia coli</i>, <i>Haemophilus influenzae</i> (including &szlig;-lactamase-producing ampicillin-resistant strains), <i>Klebsiella sp</i>, and <i>Proteus mirabilis</i>.