Cefaclor In Treatment Research Articles

Pharmacokinetics and Pharmacodynamic dosage adaptation of cefaclor in systemic infections

Cefaclor was one of the commonly used antimicrobials in Serbia, but due to fast development of resistance, other oral cephalosporins rapidly upstaged cefaclor and cefaclor was removed from the list of the drugs reimbursed by the National Health Insurance Fund. Use of recommended dosing regimen (250-500mg/8-12h) is likely to result in sub-therapeutic concentrations for a wide portion of dosing interval due to short half-life of cefaclor, which may facilitate development of resistance. The aim of this study was to determine adequate dosing interval for cefaclor in treatment of systemic infections using Pharmacokinetic (PK) and pharmacodznamic (PD) parameters with special regard to postantibiotic effect (PAE). PK profile of cefaclor in healthy volunteers and PK/PD indices relating to efficacy of cephalosporins were determined, as well as minimum inhibitory concentration (MIC) and PAE of cefaclor on 4 susceptible bacteria. Cmax of 23.142 ± 5.67 µg/mL was measured after 40-60 minutes. Tmax was 0.72 ± 0.13 hours. Calculated AUC(0-t) was 29.148 ± 9.27 µg/mL/h. MICs were in range of 1-2 µg/mL. Cefaclor induced PAE of 1-2h. There was inconsistency between standard dosing regimen and PK/PD parameters. Main PK/PD index relating to efficacy of cephalosporins (%t>MIC) for the 750mg dose was 33.5–42.1%. PK/PD breakpoints for cefaclor were between 0.3-1µg/mL. Even the maximum doze with standard dosing intervals is not appropriate for eradication of susceptible organisms. Short PAE can’t compensate for sub-inhibitory concentrations at the half of the dosing interval. In reference to PK/PD parameters cefaclor should be administered every 6h for the doses of 500mg and 750mg, and every 4-4.5h for the 250mg dose in order to maximize its therapeutic efficacy and minimize development of resistance.

Analysis of Clinical Efficacy of Yiqing capsules and Cefaclor Tablets in Treatment of Simplex Anaphylactoid Purpura

Objective To investigate the efficacy of Yiqing capsules and Cefaclortablets in the treatment of simplex anaphylactoid purpura. Methods In this randomized,simple-blind, controlled study, all of 191 simplex anaphylactoid purpura patients,the throat secretion Group A βhemolytic streptococci antigen test was positive ,92 patients of control group were treated Cefaclor tablets and regular treatment,99 patients of test group were Yiqing capsules and Cefaclor tablets. Results After 10 days treatment,the clinical efficacy of the test group and the control group were 91.9% ,75.0% ,the test group was obviously higher than that of the control group(P ＜ 0.01), and the negative rate of the throat secretion Group A βhemolytic Streptococci antigen test of the test group was higher than that of control group, (P ＜0.01). the commencements of response of the test group was earlier than that of the control group(P ＜0. 01) ,the frequencies of recurrence of the test group were lower than that of the control group (P ＜ 0. 05).Conclusion Yiqing capsules combined cefaclor in treatment of simplex allergic purpura could improve efficacy, and reduce the treatment time. Key words: Purpura, schoenlein-henoch; Yiqing capsules; Cefaclor

Randomized double-blind trial of the comparative efficacy and safety of cefpodoxime proxetil and cefaclor in the treatment of acute community-acquired pneumonia

A randomized, controlled, double-blind, double-dummy, multicenter study compared the efficacy and safety of cefpodoxime proxetil with that of cefaclor in the outpatient treatment of community-acquired pneumonia. A total of 325 patients received 7 to 14 days of either 200 mg of cefpodoxime as cefpodoxime proxetil twice daily (n = 216) or 500 mg of cefaclor three times daily (n = 109). All study criteria were met by 125 patients (cefpodoxime, 77; cefaclor, 48). Streptococcus pneumoniae and Haemophilus influenzae were the most commonly identified pathogens. Of 198 pathogenic bacteria isolated from sputum, cefpodoxime susceptibility was tested in 178 and cefaclor susceptibility in 181. Isolates were more susceptible to cefpodoxime than to cefaclor ( P = 0.001): 94% were susceptible to cefpodoxime and 82% to cefaclor; 3% were moderately susceptible to cefpodoxime and 5% to cefaclor; 3% were resistant to cefpodoxime and 13% were resistant to cefaclor. Clinical outcome in the two treatment groups was similar: 77% of cefpodoxime-treated patients and 71% of cefaclor-treated patients were cured; 19% of cefpodoxime-treated and 25% of cefaclor-treated patients improved; and 4% of patients in each group were considered treatment failures. Gastrointestinal complaints were the most frequently reported drug-related adverse event (10%) in the cefpodoxime group, and dermatologic problems (5%) were the most commonly encountered drug-related adverse event in the cefaclor group. Overall frequencies of drug-related adverse events were similar (16% for cefpodoxime vs 14% for cefaclor) in the two groups. Cefpodoxime proxetil was as effective and as well tolerated as cefaclor in the outpatient treatment of community-acquired pneumonia.

A double blind comparative study of cefditoren pivoxil versus cefaclor in treatment of skin and skin structure infections

A double blind comparative study of cefditoren pivoxil versus cefaclor in treatment of skin and skin structure infections

Free Cefixime in Community Health Centers

To Editor. — As family practitioners working in community health centers, we were dismayed to receive a letter (March 1, 1990) informing us of National Association of Community Health Centers' involvement with Suprax Family Health Fund. Lederle Laboratories has donated $10 million worth of cefixime to be distributed free of charge to patients at community health clinics. Cefixime, a third-generation cephalosporin, is marketed by Lederle for the treatment of otitis media, pharyngitis, tonsillitis, acute bronchitis, acute exacerbations of chronic bronchitis, and uncomplicated urinary tract infections. The Medical Letter on Drugs and Therapeutics reviewed clinical trials comparing cefixime with amoxicillin and cefaclor in treatment of urinary tract infection, otitis media, pharyngitis, and bronchitis and concludes that cefixime... demonstrated no clinical advantage over previously available drugs including some that cost much less. 2 We are concerned that using a third-generation cephalosporin to treat uncomplicated infections may select for

762 CEFACLOR (B.I.D. v T.I.D.)v AMOXICILLIN IN THE TREAMENT OF ACUTE OTITIS MEDIA (AOM)

A double-blind randomized study was designed to evaluate the efficacy of Cefaclor in treatment of AOM. 72 children with AOM were randomly assigned to three groups:Cefaclor 40mgm/kg/day BID, (A,n=25),TID (B,n=23)Amoxicillin 40mgm/kg/day TID (C,n=24). All patients were treated 14 days. The age range of the patients was 1mo-16yr. Tympanocentesis (Tymp) was done on day 1 in 56; 19 had +ve cultures for pathogens(A=11, B=3, C=5). 12 patients had Tymp on day 2 of therapy for persistance of pathogens;1(B) had +ve culture. All organisms were sensitive to Amoxicillin and Cefaclor. Clinical response was evaluated on day 2-4 and day 14-18 for resolution of AOM and for middle ear effusion (MEF) by pneumatoscopy and tympanometry. All patients had defervescence of symptoms (fever, earache and irritability)within 24hrs. The results in the 3 groups were as follows: Our results show that Cefaclor is as effective as Amoxicillin in the treatment of AOM. Further, Cefaclor BID was as effective as TID regimens. BID regimen has the advantage of better patient compliance, especially if this can be confirmed in larger studies.