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Decreased absorption of cefaclor in short bowel syndrome
Insights
Oral cefaclor absorption is unpredictable in children with short bowel syndrome. This case highlights the need to monitor antibiotic serum concentrations to ensure treatment efficacy in patients with gastrointestinal absorptive issues.
Area of Science:
- Pediatric Pharmacology
- Gastroenterology
- Infectious Diseases
Background:
- Short bowel syndrome can significantly impact oral medication absorption.
- Antibiotic efficacy relies on achieving therapeutic serum concentrations.
Abstract:
Oral cefaclor is rapidly absorbed in patients with a shortened gastrointestinal tract (23 cm). A case is reported of a 27-month-old female child who had received oral cefaclor for five days in treatment of otitis media. The child had had a bowel resection at birth. She did not respond to oral therapy with cefaclor and was admitted to the hospital, where she received cefamandole intramuscularly. The patient recovered in five days. Further investigation using cefaclor with this patient demonstrated serum concentrations below the minimum inhibitory concentration of Hemophilus influenzae, pneumococcus, and many other organisms. When oral antibiotics are prescribed, it is necessary to monitor serum concentrations to ensure absorption.