Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C16H16ClN3O4.H2O |
| Molecular Weight | 367.784 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 3 / 3 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
O.N[C@@H](C(=O)N[C@H]1[C@H]2CCC(Cl)=C(N2C1=O)C(O)=O)C3=CC=CC=C3
InChI
InChIKey=GPYKKBAAPVOCIW-HSASPSRMSA-N
InChI=1S/C16H16ClN3O4.H2O/c17-9-6-7-10-12(15(22)20(10)13(9)16(23)24)19-14(21)11(18)8-4-2-1-3-5-8;/h1-5,10-12H,6-7,18H2,(H,19,21)(H,23,24);1H2/t10-,11-,12+;/m1./s1
| Molecular Formula | C16H16ClN3O4 |
| Molecular Weight | 349.769 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 3 / 3 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
| Molecular Formula | H2O |
| Molecular Weight | 18.0153 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
DescriptionSources: https://www.ncbi.nlm.nih.gov/pubmed/2621166Curator's Comment: Description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/7686466 | http://www.rxlist.com/lorabid-drug.htm
Sources: https://www.ncbi.nlm.nih.gov/pubmed/2621166
Curator's Comment: Description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/7686466 | http://www.rxlist.com/lorabid-drug.htm
Loracarbef (KT3777) is carbacephem antibiotic structurally identical to cefaclor, except that the sulfur atom of position 1 of the cephem nucleus has been replaced by carbon. It showed good affinity for penicillin-binding proteins. 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. Loracarbef has been indicated in the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL2354204 Sources: https://www.ncbi.nlm.nih.gov/pubmed/2621166 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Curative | LORABID Approved UseLoracarbef is indicated in the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below. (As recommended dosages, durations of therapy, and applicable patient populations vary among these infections, please see DOSAGE AND ADMINISTRATION for specific recommendations.)
Lower Respiratory Tract: Secondary Bacterial Infection of Acute Bronchitis caused by S. pneumoniae, H. influenzae(including b-lactamase-producing strains), or M. catarrhalis (including b-lactamase-producing strains).
Acute Bacterial Exacerbations of Chronic Bronchitis: caused by S. pneumoniae, H. influenzae (including b-lactamase-producing strains), or M. catarrhalis (including b-lactamase-producing strains).
Pneumonia: caused by S. pneumoniae or H. influenzae (non-b-lactamase-producing strains only). Data are insufficient at this time to establish efficacy in patients with pneumonia caused by b-lactamase-producing strains of H. influenzae.
Upper Respiratory Tract: Otitis Media† caused by S. pneumoniae, H. influenzae (including b-lactamase-producing strains), M. catarrhalis (including b-lactamase-producing strains), or S. pyogenes.
Acute Maxillary Sinusitis:† caused by S. pneumoniae, H. influenzae (non-b-lactamase-producing strains only), or M. catarrhalis (including b-lactamase-producing strains). Data are insufficient at this time to establish efficacy in patients with acute maxillary sinusitis caused by b-lactamase-producing strains of H. influenzae.
† NOTE: In a patient population with significant numbers of b-lactamase-producing organisms, loracarbef's clinical cure and bacteriological eradication rates were somewhat less than those observed with a product containing a b-lactamase inhibitor. Loracarbef's decreased potential for toxicity compared to products containing b-lactamase inhibitors along with the susceptibility patterns of the common microbes in a given geographic area should be taken into account when considering the use of an antimicrobial (see CLINICAL STUDIES.)
Pharyngitis and Tonsillitis: caused by S. pyogenes. (The usual drug of choice in the treatment and prevention of streptococcal infections, including the prophylaxis of rheumatic fever, is penicillin administered by the intramuscular route. Loracarbef is generally effective in the eradication of S. pyogenes from the nasopharynx; however, data establishing the efficacy of loracarbef in the subsequent prevention of rheumatic fever are not available at present.) For information on use in pediatric patients, see PRECAUTIONS, Pediatric Use.
Skin and Skin Structure: Uncomplicated Skin and Skin Structure Infections caused by S. aureus (including penicillinase-producing strains) or S. pyogenes. Abscesses should be surgically drained as clinically indicated.
Urinary Tract: Uncomplicated Urinary Tract Infections (cystitis) caused by E. coli or S. saprophyticus*.
NOTE: In considering the use of loracarbef in the treatment of cystitis, loracarbef's lower bacterial eradication rates and lower potential for toxicity should be weighed against the increased eradication rates and increased potential for toxicity demonstrated by some other classes of approved agents (see CLINICAL STUDIES.)
Uncomplicated Pyelonephritis: caused by E. coli.
*Although treatment of infections due to this organism in this organ system demonstrated a clinically acceptable overall outcome, efficacy was studied in fewer than 10 infections.
Culture and susceptibility testing should be performed when appropriate to determine the causative organism and its susceptibility to loracarbef. Therapy may be started while awaiting the results of these studies. Once these results become available, antimicrobial therapy should be adjusted accordingly. Launch Date1991 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
19.21 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1468429 |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF serum | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
13.64 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1468429 |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF serum | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
8 μg/mL |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF plasma | Homo sapiens population: UNHEALTHY age: CHILD sex: UNKNOWN food status: UNKNOWN |
|
14 μg/mL |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF plasma | Homo sapiens population: UNHEALTHY age: CHILD sex: UNKNOWN food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
33.04 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1468429 |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF serum | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
35.38 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1468429 |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF serum | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
70.31 min EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1468429 |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF serum | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
102.33 min EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1468429 |
400 mg single, oral dose: 400 mg route of administration: Oral experiment type: SINGLE co-administered: |
LORACARBEF serum | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
Doses
| Dose | Population | Adverse events |
|---|---|---|
400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
Disc. AE: Diarrhea, Allergic exanthema... AEs leading to discontinuation/dose reduction: Diarrhea (1 patient) Sources: Allergic exanthema (1 patient) Abdominal pain (1 patient) |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
Disc. AE: Hypersensitivity, Diarrhea... AEs leading to discontinuation/dose reduction: Hypersensitivity (16 patients) Sources: Diarrhea (12 patients) Nausea and vomiting (16 patients) Abdominal pain (9 patients) Headache (5 patients) Neurologic disorder NOS (2 patients) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Abdominal pain | 1 patient Disc. AE |
400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
| Allergic exanthema | 1 patient Disc. AE |
400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
| Diarrhea | 1 patient Disc. AE |
400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
| Diarrhea | 12 patients Disc. AE |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
| Hypersensitivity | 16 patients Disc. AE |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
| Nausea and vomiting | 16 patients Disc. AE |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
| Neurologic disorder NOS | 2 patients Disc. AE |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
| Headache | 5 patients Disc. AE |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
| Abdominal pain | 9 patients Disc. AE |
30 mg/kg 1 times / day steady, oral Highest studied dose Dose: 30 mg/kg, 1 times / day Route: oral Route: steady Dose: 30 mg/kg, 1 times / day Sources: |
unhealthy, children and adults Health Status: unhealthy Age Group: children and adults Sex: M+F Sources: |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Progress in the development of early diagnosis and a drug with unique pharmacology to improve cancer therapy. | 2008-10-13 |
|
| The effect of four different types of diet on the bioavailability of loracarbef. | 2008-03-20 |
|
| Antimicrobial susceptibility of Staphylococcus aureus isolated from colonized hospital personnel. | 2007-06-19 |
|
| Prediction of genotoxicity of chemical compounds by statistical learning methods. | 2005-06 |
|
| Twice-daily dosing of loracarbef 15 mg/kg versus 30 mg/kg in the treatment of children with acute sinusitis. | 2005 |
|
| [Evaluation of predisposing factors and bacteriologic agents in pediatric rhinosinusitis]. | 2005 |
|
| Penicillin V, loracarbef and clindamycin in tonsillar surface fluid during acute group A streptococcal pharyngotonsillitis. | 2005 |
|
| Staphylococcal skin infections in children: rational drug therapy recommendations. | 2005 |
|
| Limited spread of penicillin-nonsusceptible pneumococci, Skåne County, Sweden. | 2004-06 |
|
| Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes. | 2004-03 |
|
| Antimicrobial susceptibility patterns, beta-lactamases, and biochemical identification of Yokenella regensburgei strains. | 2004-01 |
|
| Cefdinir: a review of its use in the management of mild-to-moderate bacterial infections. | 2004 |
|
| Natural antibiotic susceptibility of Ewingella americana strains. | 2003-10 |
|
| Natural antibiotic susceptibility of strains of Serratia marcescens and the S. liquefaciens complex: S. liquefaciens sensu stricto, S. proteamaculans and S. grimesii. | 2003-07 |
|
| [Haemophilus influenzae and betalactam resistance: description of bla TEM gene deletion]. | 2003-06 |
|
| Serologically documented loracarbef (Lorabid)-induced immune thrombocytopenia. | 2003-05 |
|
| Natural antimicrobial susceptibilities of strains of 'unusual' Serratia species: S. ficaria, S. fonticola, S. odorifera, S. plymuthica and S. rubidaea. | 2003-04 |
|
| [Sensitivity of Haemophilus influenzae isolates in Spain to 17 oral antibiotics]. | 2003-03 |
|
| Natural antibiotic susceptibility of Proteus spp., with special reference to P. mirabilis and P. penneri strains. | 2003-02 |
|
| Contribution of efflux to cefuroxime resistance in clinical isolates of Escherichia coli. | 2003 |
|
| Natural antibiotic susceptibility of Enterobacter amnigenus, Enterobacter cancerogenus, Enterobacter gergoviae and Enterobacter sakazakii strains. | 2002-09 |
|
| The fecal microflora of 1-3-month-old infants during treatment with eight oral antibiotics. | 2002-06 |
|
| Patient, physician, and nurse satisfaction with antibiotics. | 2002-06 |
|
| Antimicrobial susceptibilities of clinical isolates of Haemophilus influenzae and Moraxella catarrhalis collected during 1999-2000 from 13 countries. | 2001-12 |
|
| Structures of ceftazidime and its transition-state analogue in complex with AmpC beta-lactamase: implications for resistance mutations and inhibitor design. | 2001-08-07 |
|
| Effect of step-down therapy of ceftriaxone plus loracarbef versus parenteral therapy of ceftriaxone on the intestinal microflora in patients with community-acquired pneumonia. | 2001-07 |
|
| Antibiotic susceptibilities among recent clinical isolates of Haemophilus influenzae and Moraxella catarrhalis from fifteen countries. | 2001-01 |
|
| Compliance issues related to the selection of antibiotic suspensions for children. | 2001-01 |
|
| Transport mechanisms responsible for the absorption of loracarbef, cefixime, and cefuroxime axetil into human intestinal Caco-2 cells. | 1994-04-20 |
|
| Loracarbef. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic efficacy. | 1993-05 |
|
| Loracarbef: a new orally administered carbacephem antibiotic. | 1993-03 |
|
| Loracarbef (LY163892) versus cefaclor and norfloxacin in the treatment of uncomplicated pyelonephritis. | 1992-06-22 |
|
| Loracarbef (LY163892) versus cefaclor in the treatment of bacterial skin and skin-structure infections in an adult population. | 1992-06-22 |
|
| Loracarbef versus penicillin VK in the treatment of streptococcal pharyngitis and tonsillitis in an adult population. | 1992-06-22 |
|
| The carbacephems: a new beta-lactam antibiotic class. | 1992-06-22 |
Patents
Sample Use Guides
In the treatment of adults with pharyngitis, acute bronchitis, tonsillitis and uncomplicated infections of skin and skin structures, loracarbef was studied at a dosage of 200mg twice daily. Patients with acute pneumonia, sinusitis and uncomplicated pyelonephritis were treated with 400mg twice daily in clinical studies. Seven-day courses of 200 or 400mg twice daily were used to treat acute exacerbations of chronic bronchitis (acute superimposed on chronic). A once-daily dose of 200mg is used to treat acute cystitis.
In infants and children, 30 mg/kg in divided doses 12-hourly is used to treat acute otitis media, while 15 mg/kg is recommended for the treatment of pharyngitis, tonsillitis and impetigo.
Dosage should be adjusted in patients with renal impairment whose creatine clearance is below 2.9 L/h (49 ml/min).
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/2621166
The MIC50 of loracarbef (KT3777) ranged from 0.2 to 3.13 micrograms/ml for clinical isolates of Staphylococcus aureus, Streptococci, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae.
| Substance Class |
Chemical
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| Record UNII |
3X11EVM5SU
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Validated (UNII)
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NCI_THESAURUS |
C357
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NDF-RT |
N0000175488
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WHO-ATC |
J01DC08
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WHO-VATC |
QJ01DC08
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569
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CHEMBL1013
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100000089072
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Loracarbef
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28981
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214480
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DB00447
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SUB23249
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C054920
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C47588
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m6903
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LORACARBEF
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121961-22-6
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