Cephalosporins cefaclor

B. Vilanova, F. Munoz, J. Donoso, J. Frau, F. G. Blanco, The Degradation Mechanism of an Oral Cephalosporin Cefaclor , Helv. Chim. Acta 1996, 79, 1793-1801. 

Patients allergic to penicillin may be cross-sensitive to cephalosporins. Cephalosporins (cefaclor, first-generation cephalosporin) are therefore avoided in these patients and instead macrolides (for example, erythromycin) are generally administered. Ketoconazole is an imidazole antifungal agent. 

INTERMEDIATE-SPECTRUM (SECOND-GENERATION) CEPHALOSPORINS Cefaclor (generic, Ceclor)... 

It has also been reported that patients with allergic-like events after penicillin treatment have had a markedly risk of events after subsequent cephalosporin antibiotics. Cross-reactivity is not an adequate explanation for this increased risk and the data obtained indicate that cephalosporins can be considered for patients with penicillin allergy <2006MI354.ell>. Comparisons of parenteral broad-spectrum cephalosporins have been tested against bacteria isolated from pediatric patients. The results have indicated that cefepime has been the most broad-spectrum cephalosporin analyzed and it is a very potent alternative for the treatment of contemporary pediatric infections in North America <2007MI109>. The historical safety of the most commonly used oral cephalosporins has been reviewed <2007MIS67>. The antimicrobial spectrum and in vitro potency of the most frequently prescribed orally administered cephalosporins (cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime axetil and cephalexin has also been reviewed <2007MIS5>. 

ANTICOAGULANTS-ORAL CEPHALOSPORINS Certain cephalosporins (cefaclor, cefixime, ceftriaxone) may t efficacy of oral anticoagulants These cephalosporins have vitamin K antagonistic activity, which adds to the action of oral anticoagulants. Monitor INR closely any significant t INR may require vitamin K therapy. If possible, use an alternative cephalosporin... 

Yang L, Wei Z (2003) Enhanced enzymatic synthesis of a semi-synthetic cephalosporin, cefaclor, with in situ product removal. Biotechnol Lett 25 1195-1198... 

Penicillins (penicilloyl andpenicillanyl determinants of benzylpenicUlin, phenoxymethylpenicillin, ampiciUin, amoxicillin, ticarcillin, flucloxacillin, andcloxacUlin) (Chap. 5) cephalosporins (cefaclor, cephalothin, cefalexin, ceftazidime, ceftriaxone, cefuroxime, cefotaxime, cefadroxil) (Chap. 5) tetracycline and doxycycline sulfamethoxazole ... 

Cephalosporins first entered the marketplace in 1964, when cephalothin (27) and cephaloridine (51), which are both injectable, were launched. By the late 1970s, the injectable cephalosporins had become important therapeutic agents in the hospitals. Also in 1964 the first oral cephalosporin, cephaloglycin [3577-01 -3] C gH N OgS, was launched only to be displaced by the end of the year by cephalexin (12). For years cephalexin was the leading oral cephalosporin on the market. It has since been displaced by cefaclor (13). With the advent of the more -lactamase stable cephalosporins such as cefoxitin (23) and cefuroxime (35), and the more potent agents such as cefotaxime (36) and other third-generation compounds, cephalosporins now dominate the antibiotic market worldwide. 

Cephalosporins (e.g., cefazolin, cefoxitin, cefaclor, cephalexin, and cephalothin)... 

The structures of the drugs used as a small test set for the model are listed in Table 17.1. Loperamide and asimadoline are P-gp substrates terfenadine and ebastine are compounds that are rapidly metabolized alprazolam, dobazam, di-and mono-hydroxy-L66858 [11] are benzodiazepines testosterone and corticosterone are hormones and cefadroxyl, cefaclor, cephalotin and cefmetazole are cephalosporins [12]. Finally, peptides 1 to 10 are peptidomimetic drugs [13]. 

Second-generation cephalosporins—IV cefuroxime po cefaclor, cefditoren, cefprozil, cefuroxime axetil, and loracarbef. Third-generation cephalosporins—po cefdinir, cefixime, cefetamet, cefpodoxime proxetil, and ceftibuten. 

Penicillins Ampicillin Amoxicillin-davulanic add Cephalosporins Cephalexin Cefaclor Cefadroxil Cefuroxime Cefixime Cefzil... 

In addition, the last of the shown drugs, moxalactam, contains a hydrooxazine ring instead of the dihydrothiazine ring common to all other cephalosporins. A few cephalosporins contain an additional methoxy group at position C7 of aminocephalosporanic acid (cefotetan, cefaclor). 

Second-generation cephalosporins (cefuroxime, cefamandole, cefoxitin, cefotetan, cefaclor, and others) are characterized by high activity with respect to Gram-positive microorganisms that are resistant to beta-lactamase action. They do not have a noticible effect on enterococci. 

Cephalexin, cefaclor, cefprozil, cefadroxil, ceftibuten, and loracarbef are well absorbed from the Gl tract. Cephalosporins are widely distributed to most tissues and fluids. First and second generation agents do not readily enter cerebrospinal fluid (CSF), except cefuroxime, even when meninges are inflamed. Third generation compounds readily diffuse into the CSF of patients with inflamed meninges. However, CSF levels of cefoperazone are relatively low. Most cephalosporins and metabolites are primarily excreted renally. 

Microemulsion electrokinetic chromatography was introduced to study the affinity of various cephalosporins [cefpim, cefpirom, cefaloridin, cefaclor, cephalexin, cefuroxim, cefotaxim] in microemulsions and micellar (MC) systems. The affinity of various cephalosporins in microemulsions was characterized calculating the capacity factor. The capacity factor values of the cephalosporins in micellar systems and in microemulsions are given in Table... 

CEPHALOSPORINS, SECOND GENERATION Cefaclor (Ceclor, Cefprozil (Cefzil)... 

COPD exacerbations. Therefore, in exacerbation treatment with antibiotics is justified when the patient has at least two of three features of increased dyspnea, increased sputum volume, and sputum pu-rulence. Antibiotic choice will depend on local experience derived from local bacteriological sensitivity data. Older, less costly compounds such as tetracycline, doxycycline, amoxicillin, erythromycin, cefaclor etc. are often as effective as newer, more expensive ones. If resistant organisms are suspected or when the severity of the patients clinical condition puts them at high-risk of treatment failure, a second or third generation cephalosporin, fluoroquinolone, newer macrolide or broad-spectrum penicillin may be preferred. In cases of recurrent infection prolonged courses of antibiotics continuous or intermittent, may be useful. 

Loracarbef Lorabid) is a synthetic p-lactam antibiotic of the carbacephem class. The chemical structure of loracarbef is similar to that of cefaclor. Selected pharmacokinetic information appears in Table 45.2. Lora-carbef s spectrum of antibacterial activity resembles those of the second-generation cephalosporins. Comparative clinical trials reveal similar outcomes in patients treated with cefaclor, cefprozil, and loracarbef. 

Penicillins (bactericidal inhibit cell wall crosslinking) e.g., benzylpenicillin, phenoyxmethylpenicillin, ampicillin, amoxicillin, flu-cloxacillin, methicillin, piperacillin Cephalosporins (bactericidal inhibit cell wall crosslinking) e.g., cefaclor, cefalexin, cefradine, cefuroxime, cefazolin, cefotaxime, ceftriaxone, cefoxitin, cefsulodin, ceftazidime, ceftizoxime Monobactams (bactericidal, P-lactam-like activity) e.g., aztreonam... 

Members of the second-generation cephalosporins include cefaclor, cefamandole, cefonicid, cefuroxime, cefprozil, loracarbef, and ceforanide and... 

First-generation cephalosporins cefazolin for parenteral administration cefadroxil or cephalexin for oral administration. Second-generation cephalosporins cefuroxime for parenteral administration cefaclor, cefuroxime axetil, cefprozil, for oral administration. Third-generation cephalosporins ceftazidime, cefotaxime, ceftriaxone for parenteral administration cefixime, cefpodoxime, ceftibuten, cefdinir, cefditoren for oral administration. Fourth-generation cephalosporin cefepime for parenteral administration. Cephamycins cefoxitin and cefotetan for parenteral administration. 

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