Decreased absorption of cefaclor in short bowel syndrome

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.