Ceclor


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Ceclor

 [se´klor]
trademark for a preparation of cefaclor, a broad-spectrum cephalosporinantibiotic.

cefaclor

(sef-a-klor) ,

Raniclor

(trade name),

Ceclor

(trade name)

Classification

Therapeutic: anti infectives
Pharmacologic: second generation cephalosporins
Pregnancy Category: B

Indications

Treatment of the following infections caused by susceptible organisms:
  • Respiratory tract infections,
  • Skin and skin structure infections,
  • Urinary tract infections,
  • Otitis media.

Action

Binds to bacterial cell wall membrane, causing cell death.

Therapeutic effects

Bactericidal action against susceptible bacteria.
Similar to that of first-generation cephalosporins but has increased activity against several other gram-negative pathogens including:
  • Haemophilus influenzae,
  • Escherichia coli,
  • Klebsiella pneumoniae,
  • Proteus mirabilis.
Not active against methicillin-resistant staphylococci or enterococci.

Pharmacokinetics

Absorption: Well absorbed after oral administration.
Distribution: Widely distributed. Penetration into CSF is poor. Crosses the placenta and enters breast milk in low concentrations.
Metabolism and Excretion: Excreted primarily unchanged by the kidneys.
Half-life: 30–60 min (increased in renal impairment).

Time/action profile

ROUTEONSETPEAKDURATION
POrapid30–60 min6–12 hr
PO-CDunknownunknown12 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity to cephalosporins; Serious hypersensitivity to penicillins.
Use Cautiously in: Renal impairment ; History of GI disease, especially colitis; Pregnancy and lactation (has been used safely).

Adverse Reactions/Side Effects

Central nervous system

  • seizures (very high doses) (life-threatening)

Gastrointestinal

  • pseudomembranous colitis (life-threatening)
  • diarrhea
  • nausea
  • vomiting

Dermatologic

  • rashes
  • urticaria

Hematologic

  • agranulocytosis
  • bleeding
  • eosinophilia
  • hemolytic anemia
  • neutropenia

Miscellaneous

  • allergic reactions including anaphylaxis and serum sickness (life-threatening)
  • superinfection

Interactions

Drug-Drug interaction

Probenecid decreases excretion and increases blood levels.Antacids decrease absorption.

Route/Dosage

Oral (Adults) 250–500 mg q 8 hr or 375–500 mg q 12 hr as extended-release tablets.
Oral (Children >1 mo) 6.7–13.4 mg/kg q 8 hr or 10–20 mg/kg q 12 hr (up to 1 g/day).

Availability (generic available)

Capsules: 250 mg, 500 mg
Extended-release tablets (CD): 375 mg, 500 mg
Chewable tabletfruity: 125 mg, 187 mg, 250 mg, 375 mg
Oral suspensionstrawberry: 125 mg/5 mL, 187 mg/5 mL, 250 mg/5 mL, 375 mg/5 mL

Nursing implications

Nursing assessment

  • Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and during therapy.
  • Before initiating therapy, obtain a history to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response.
  • Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.
  • Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify the physician or other health care professional immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.
  • Lab Test Considerations: May cause positive results for Coombs' test.
    • May cause increased serum AST, ALT, alkaline phosphatase, bilirubin, LDH, BUN, and creatinine.
    • May rarely cause neutropenia, agranulocytosis, and eosinophilia.

Potential Nursing Diagnoses

Risk for infection (Indications,  Side Effects)
Diarrhea (Adverse Reactions)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Oral: Administer around the clock. Chewable tablets, capsules, or suspension may be administered on full or empty stomach. Administration with food may minimize GI irritation. Extended-release tablets should be taken with food. Shake oral suspension well before administering. Suspension is stable for 14 days after reconstitution if refrigerated.
    • Do not administer within 1 hr of taking antacids.
    • Do not crush, break, or chew extended-release tablets.

Patient/Family Teaching

  • Instruct patient to take medication around the clock at evenly spaced times and to finish the medication completely, even if feeling better. Missed doses should be taken as soon as possible unless almost time for next dose; do not double doses. Instruct patient to use calibrated measuring device with suspension. Advise patient that sharing of this medication may be dangerous.
  • Advise patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy.
  • Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.

Evaluation/Desired Outcomes

  • Resolution of signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.
References in periodicals archive ?
Under the deal, all employees at the Ceclor manufacturing facility and certain employees from shared functions will be offered the opportunity to remain at the facility and continue to work with Eddingpharm.
As part of the transaction, all employees at the Ceclor manufacturing facility and certain employees from shared functions will be offered the opportunity to remain at the facility and continue to work with Eddingpharm.
Target: Two legacy Lilly antibiotic medicines, Ceclor and Vancocin, as well as a manufacturing facility in Suzhou, China that produces Ceclor
In various press releases, Dura made statements to the effect that Spiros was on track for FDA approval and that its respiratory antibiotic Ceclor CD was experiencing strong sales and had increased its market share significantly.
TABLE 4 Compliance-Enhancing Ranking of Antibiotic Suspensions STRONGLY COMPLIANCE-ENHANCING * Amoxicillin * Cefdinir (Omnicef) * Loracarbef (Lorabid) * Cefaclor (Ceclor) * Cefixime (Suprax) MODERATELY COMPLIANCE-ENHANCING * Cefprozil (Cefzil) * Ceftibuten (Cedax) EQUIVOCAL COMPLIANCE-ENHANCING * Azithromycin (Zithromax) NOT COMPLIANCE-ENHANCING * Amoxicillin-clavulanate (Augmentin) * Erythromycin-sulfasoxazole (Pediazole) * TMP-SMX (Bactrim or Septra) DISCOURAGES COMPLIANCE * Cefpodoxime (Vantin) * Cefuroxime (Ceftin) * Clarithromycin (Biaxin) TMP-SMX, trimethoprim sulfamethoxazole Sources: Adapted from Steele RW, et al.
Some of the commonly used brand names are Ceclor, Ceftin, Kefzol, Velosef, and Omnicef (see second paragraph, previous page, for additional names).
Avoidant Features Axis III: Ceclor and Codeine allergies Axis IV: Problems with social environment, educational problems, problems related to interactions with the legal system/ crime.
Of the 626 for whom the drug they took was known, 40% reported a reaction to a penicillin or ampicillin or amoxicillin, 56% reported a reaction to a penicillin and then another reaction to a different antibiotic such as a cephalosporin, and 4% reported a reaction to cefaclor (Ceclor) specifically.
* Eli Lilly and Co.'s major products include Prozac (an antidepressant), Axid (antiulcer), Kefzol, Ceclor, Lorabid (antibiotics), Zyprexa (schizophrenia), Humatrope (human growth hormone), Humulin (insulin), Reopro (angioplasty) and Evista (osteoporosis).
In another instance, second-generation cephalosporin antibiotics on the approved list include Cefaclor, Cefaclor ER, Ceftin, Cefzil, Ceptaz, and Rocephin, while Ceclor CD, Ceclor, Cefotan, and Lorabid must receive authorization.
In another instance, second-generation cephalosporin antibiotics on the state's approved list include Cefaclor, Cefaclor ER, Ceftin, Cefril, Ceptaz, and Rocephin, while Cedor CD, Ceclor, Cefotan, and Lorabid must receive prior authorization.
[][] Amoxicillin 01 Amoxicillin and Clavulanic Acid (Augmentin) 02 Azithromycin (Zithromax) 03 Cafaclor (Ceclor) 04 Cefixime (Suprax) 05 Cefpodoxime (Vantin) 06 Cefprozil (Cefzil) 07 Cetriaxone (Rocephin) 08 Clarithromycin (Biaxin) 09 Erythromycin and Sulfisoxazone (Pediazole) 10 Loracarbef (Lorabid) 11 Trimethoprim and Sulfamethoxazole (Bactrim, Septra) 12 Other 13 No Data 99