Loracarbef

Loracarbef Brand Name– Lorabid

What is Loracarbef

NOTE: This drug is discontinued in the US.

Loracarbef is an orally administered synthetic beta-lactam antibiotic and is a member of the carbacephem class.

Loracarbef is a synthetic structural analog of the cephalosporin cefaclor. Chemically, the dihydrothiazine ring of the loracarbef structure contains a methylene group where the sulfur atom is present on the cefaclor molecule.

The clinical utility and beta-lactamase stability of loracarbef is similar to that of the second-generation cephalosporins.

Thus loracarbef’s spectrum of activity includes pathogens frequently isolated in respiratory, urinary, skin, and soft-tissue infections.

The side effect profile of loracarbef is similar to that of other cephalosporins. The clinical efficacy of loracarbef is also comparable to that of amoxicillin and amoxicillin/clavulanic acid in patients with upper or lower respiratory tract infections.

Loracarbef was approved by the FDA in December 1991.

The manufacture and distribution of Lorabid® was discontinued in September 2006 for business reasons by King Pharmaceuticals.

There are currently no other suppliers of loracarbef in the U.S.

Indications

  1. bronchitis
  2. Citrobacter diversus
  3. Clostridium perfringens
  4. cystitis
  5. Escherichia coli
  6. Fusobacterium necrophorum
  7. Haemophilus influenzae (beta-lactamase negative)
  8. Haemophilus influenzae (beta-lactamase positive)
  9. Haemophilus parainfluenzae
  10. impetigo
  11. Klebsiella pneumoniae
  12. lower respiratory tract infections
  13. Moraxella catarrhalis
  14. Neisseria gonorrhoeae
  15. otitis media
  16. Pasteurella multocida
  17. Peptococcus niger
  18. Peptostreptococcus intermedius
  19. pharyngitis
  20. Propionibacterium acnes
  21. Proteus mirabilis
  22. pyelonephritis
  23. Salmonella sp.
  24. Shigella sp.
  25. sinusitis
  26. skin and skin structure infections
  27. Staphylococcus aureus (MSSA)
  28. Staphylococcus epidermidis
  29. Staphylococcus saprophyticus
  30. Streptococcus agalactiae (group B streptococci)
  31. Streptococcus bovis
  32. Streptococcus dysgalactiae
  33. Streptococcus pneumoniae
  34. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  35. Streptococcus sp.
  36. tonsillitis
  37. upper respiratory tract infections
  38. urinary tract infection (UTI)
  39. Viridans streptococci
  40. Yersinia enterocolitica

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anorexia
  4. candidiasis
  5. cholestasis
  6. diarrhea
  7. dizziness
  8. elevated hepatic enzymes
  9. eosinophilia
  10. erythema multiforme
  11. headache
  12. hypoprothrombinemia
  13. insomnia
  14. jaundice
  15. leukopenia
  16. maculopapular rash
  17. nausea
  18. peripheral vasodilation
  19. pruritus
  20. pseudomembranous colitis
  21. seizures
  22. serum sickness
  23. Stevens-Johnson syndrome
  24. superinfection
  25. thrombocytopenia
  26. toxic epidermal necrolysis
  27. urticaria
  28. vaginitis
  29. vomiting

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • breast-feeding
  • carbapenem hypersensitivity
  • cephalosporin hypersensitivity
  • colitis
  • diarrhea
  • geriatric
  • GI disease
  • infants
  • inflammatory bowel disease
  • neonates
  • penicillin hypersensitivity
  • phenylketonuria
  • pregnancy
  • pseudomembranous colitis
  • renal failure
  • renal impairment
  • ulcerative colitis

Interactions

  • Colchicine; Probenecid
  • Probenecid
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid