What is the dosage and treatment regimen for Ceclor (cefaclor)?

Cefaclor (Ceclor) Dosage and Treatment Regimen

The standard dosage for cefaclor in adults is 250 mg every 8 hours orally, with doses up to 500 mg every 8 hours for more severe infections, while children should receive 20-40 mg/kg/day divided into three doses every 8 hours, with a maximum of 1 g/day. 1

Adult Dosing

• Standard dose: 250 mg every 8 hours orally
• Severe infections: 500 mg every 8 hours orally
• Maximum daily dose: 1.5 g/day

Pediatric Dosing

• Standard dose: 20 mg/kg/day divided into three doses (every 8 hours)
• Severe infections/otitis media: 40 mg/kg/day divided into three doses
• Maximum daily dose: 1 g/day
• Alternative B.I.D. option for otitis media and pharyngitis: Total daily dose may be divided and administered every 12 hours 1

Pediatric Weight-Based Dosing Guide

For 20 mg/kg/day using 125 mg/5 mL suspension:

• 9 kg: 1/2 teaspoon three times daily
• 18 kg: 1 teaspoon three times daily

For 40 mg/kg/day using 125 mg/5 mL suspension:

• 9 kg: 1 teaspoon three times daily
• 18 kg: 2 teaspoons three times daily

Specific Infection Types and Duration

Respiratory Tract Infections

• Adults: 250-500 mg every 8 hours for 7-10 days 2
• Children: 20-40 mg/kg/day divided every 8 hours for 7-10 days 2
• Pneumonia: Higher doses (500 mg every 8 hours for adults, 40 mg/kg/day for children) are recommended 3

Otitis Media

• Children: 40 mg/kg/day divided every 8 hours or every 12 hours for 7-10 days 2, 1

Pharyngitis

• Children: 20 mg/kg/day divided every 8 hours or every 12 hours for at least 10 days (for β-hemolytic streptococcal infections) 1

Urinary Tract Infections

• Adults: 250 mg every 8 hours for 7-10 days 4
• Severe UTIs: 500 mg every 8 hours for 7-10 days

Skin and Soft Tissue Infections

• Adults: 250 mg every 8 hours for 7-10 days 2
• Severe infections: 500 mg every 8 hours for 7-10 days 2

Special Considerations

Renal Impairment

• No dosage adjustment is typically required in patients with impaired renal function 1

Administration

• Should be administered on an empty stomach for optimal absorption 5
• Food may delay absorption 5

Treatment Duration

• For β-hemolytic streptococcal infections: minimum of 10 days 1
• For most other infections: 7-10 days, or until 3-5 days after all signs of infection have disappeared 1, 6

Clinical Pearls

• Cefaclor is a second-generation cephalosporin with improved gram-negative coverage compared to first-generation agents 7
• It has better activity against H. influenzae (including some β-lactamase producing strains) compared to cephalexin 5
• Common side effects are generally mild and primarily gastrointestinal in nature 5
• For pediatric patients, the suspension formulation is available in different concentrations (125 mg/5 mL and 250 mg/5 mL), so careful attention to the correct volume is important 1

Common Pitfalls to Avoid

1. Underdosing in otitis media: The higher dose of 40 mg/kg/day is recommended for otitis media in children 1
2. Inadequate duration for streptococcal infections: Always treat for a minimum of 10 days to prevent rheumatic fever 1
3. Poor timing with food: Administer on an empty stomach for optimal absorption 5
4. Insufficient dosing for severe infections: Remember to use the higher dose range (500 mg every 8 hours for adults, 40 mg/kg/day for children) for more severe infections 1

Following these dosage guidelines will help ensure optimal therapeutic outcomes while minimizing the risk of adverse effects and antimicrobial resistance.