Confirm allergy history, renal function, and prior antibiotic tolerance before dispensing cefaclor.
Absolute contraindications are limited to patients with previous immediate hypersensitivity to cefaclor or another beta-lactam. Relative contraindications emphasize risk-mitigation for children with severe penicillin reactions, renal impairment, or a history of severe cutaneous adverse reactions (SCAR).
Documented severe hypersensitivity (anaphylaxis, angioedema, Stevens-Johnson syndrome) to cefaclor or any cephalosporin
Known hypersensitivity to suspension excipients
History of IgE-mediated penicillin allergy—assess for cross-reactivity before prescribing
Creatinine clearance <30 mL/min—extend dosing interval and monitor renal function
Prior Clostridioides difficile infection or chronic colitis—monitor for recurrence
Phenylketonuria—powder for suspension contains phenylalanine
Previous serum sickness-like reaction with cefaclor—use alternative agent
Long-term therapy in renal or hepatic impairment—monitor renal function, liver enzymes, and CBC