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Cefaclor is a second-generation cephalosporin used selectively for pediatric infections based on susceptibility and guidelines.
Reserve for children who cannot tolerate aminopenicillins or in regions with high beta-lactamase–producing Haemophilus influenzae.
Typical dosing is 20–30 mg/kg/day divided every 8 hours (or 40 mg/kg/day divided twice daily for extended-release tablets in older children).
Give the suspension with food to improve tolerance; extended-release tablets must be taken within 1 hour of a meal for optimal absorption.
Assess for clinical response within 48–72 hours and switch therapy if symptoms worsen or persist.
Cefaclor is an oral second‑generation cephalosporin indicated for select pediatric infections.
Label‑supported pediatric uses include acute otitis media (AOM), streptococcal pharyngitis/tonsillitis, skin and skin structure infections, and urinary tract infections.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| Acute otitis media (beta-lactamase risk) | Children ≥6 months | No | Reserve for patients who cannot take amoxicillin or fail initial therapy; provide 40 mg/kg/day divided q8h for 10 days. |
| Acute bacterial rhinosinusitis | Children and adolescents | No | Use when first-line amoxicillin-clavulanate is contraindicated or poorly tolerated and susceptibility patterns support efficacy. |
| Group A streptococcal pharyngitis | Children and adolescents | No | Alternative for penicillin-intolerant patients; 20 mg/kg twice daily (max 500 mg/dose) for 10 days. |
| Uncomplicated skin and soft tissue infections due to susceptible organisms | Children and adolescents | No | Use culture-driven therapy; consider alternatives if MRSA is suspected. |
FDA-approved primary uses with Level A evidence
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Quick selection guides and diagnostic pearls
When to consider other medications
How to explain treatment to families
Most side effects are mild and self‑limited. Gastrointestinal symptoms (diarrhea, nausea) and rash are most common in children. Serious reactions like anaphylaxis or C. difficile–associated diarrhea (CDAD) are rare but require urgent care.
Cefaclor’s pediatric safety profile is similar to other oral cephalosporins. GI upset often improves if given with food. Allergic reactions can occur in those with beta‑lactam hypersensitivity.
Diarrhea
Common • mild
Nausea/Vomiting
Common • mild
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Rash (maculopapular)
Common • variable
Urticaria (hives)
Uncommon • moderate
Anaphylaxis
Rare • severe
Headache
Common • mild
Organized by affected organ systems
How to discuss side effects with families
Management protocols and monitoring
Common concerns and practical guidance
Precise measuring, meal-timed reminders, and full-course completion help cefaclor clear infections without resistance setbacks.
Different formulations and concentrations
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Safe preparation and measuring techniques
Tailored approaches for different ages
Solutions for common challenges
Storage guidelines and safety tips
Expert pearls and evidence-based tips
Cefaclor is a second-generation cephalosporin that targets bacterial cell wall synthesis, making it effective against many beta-lactamase–producing respiratory pathogens.
It binds penicillin-binding proteins (PBPs) and blocks transpeptidation of peptidoglycan strands, leading to weakened cell walls and bacterial lysis. Time above the minimum inhibitory concentration (MIC) drives efficacy, so consistent dosing intervals are essential.
Simple explanations and helpful analogies
Receptors, enzymes, and cellular targets
Absorption, metabolism, and elimination
Age-related differences and special populations
Cefaclor remains a useful beta-lactam when beta-lactamase coverage is needed after amoxicillin failure. These pearls help clinicians deploy it safely and effectively.
Focus on stewardship-driven selection, dosing logistics, and adverse effect surveillance.
Reserve cefaclor for otitis media or sinusitis after first-line amoxicillin/clavulanate failure or documented beta-lacta…
Extended-release cefaclor must be taken within one hour after a meal; add meal-time alerts to discharge instructions so …
Most reported 'penicillin allergies' in children are non-IgE rashes; document reaction details to avoid unnecessary broa…
Mild loose stools are common; counsel families on hydration and probiotics but advise evaluation if diarrhea is severe o…
Core insights every provider should know
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Recent updates that change how we practice
Organized by dosing, administration, and safety
How to explain treatments to families
Real-world cases with evidence-based approaches
Key numbers, algorithms, and decision tools
Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Cefaclor and monitor your child's response to treatment.
If vomiting occurs within 15 minutes, repeat the dose once unless told otherwise. If vomiting persists, contact your clinician before giving more medicine.
Mild loose stools can occur. Keep your child hydrated and call if diarrhea is severe, watery, or bloody, or if abdominal pain develops.
Yes, once fever has resolved, symptoms are improving, and your clinician has not advised otherwise. Reinforce handwashing to limit spread.
Keep refrigerated, shake well before each dose, and discard any remaining medicine after 14 days.