Loracarbef is an orally administered member of a new synthetic class of
beta-lactam antibiotics, the
carbacephems, which is characterised by enhanced chemical stability. At low concentrations (< 2 mg/L) in vitro, it inhibits Streptococcus pneumoniae, S. pyogenes, beta-haemolytic streptococci groups B, C and G. Proteus mirabilis and Moraxella catarrhalis, including
beta-lactamase-producing strains. At therapeutic plasma concentrations it is also active in vitro against most strains of Staphylococcus aureus, S. saprophyticus, Escherichia coli and
beta-lactamase-positive and -negative strains of Haemophilus influenzae. Like other
beta-lactams,
loracarbef is inactive against methicillin-resistant strains of S. aureus. When administered at dosages of 200 to 400 mg twice daily, the clinical and bacteriological efficacy of
loracarbef is comparable with that of
amoxicillin and
amoxicillin/clavulanic acid in patients with upper or lower
respiratory tract infections, and comparable with that of
cefaclor in treating
infections of the lower respiratory tract, skin and skin structures and urinary tract.
Loracarbef and
phenoxymethylpenicillin (
penicillin V) were equally effective in treating streptococcal
pharyngitis and
tonsillitis.
Loracarbef is generally well tolerated by all age groups and causes less diarrhoea than
amoxicillin/clavulanic acid. It is administered twice daily. It offers a suitable alternative to other orally administered
antibiotics for the treatment of mild to moderate
infections caused by susceptible organisms.