KLEBCIL
Clinical safety rating: caution
Comprehensive clinical and safety monograph for KLEBCIL (KLEBCIL).
Klebcillin is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidase activity, and activating autolytic enzymes.
| Metabolism | Klebcillin is primarily metabolized by hepatic esterases and undergoes hydrolysis to inactive metabolites. Minor metabolism via CYP450 enzymes (CYP3A4) occurs. |
| Excretion | Primarily renal (70-80% unchanged); minor biliary/fecal (15-20%) |
| Half-life | 2-3 hours (prolonged to 30-60 hours in severe renal impairment; adjust dosing) |
| Protein binding | 30-40% (primarily albumin) |
| Volume of Distribution | 0.2-0.4 L/kg (indicates limited extravascular distribution, primarily in extracellular fluid) |
| Bioavailability | IM: ~90% |
| Onset of Action | IV: 30-60 min; IM: 1-2 hours |
| Duration of Action | 8-12 hours (may be extended in renal dysfunction; monitor serum levels) |
| Molecular Weight | 561.6 |
KLEBCIL (ceftazidime-avibactam) 2.5 g (ceftazidime 2 g + avibactam 0.5 g) IV every 8 hours infused over 2 hours.
| Dosage form | INJECTABLE |
| Renal impairment | CrCl 31-50 mL/min: 1.25 g IV every 8 hours. CrCl 16-30 mL/min: 0.94 g IV every 12 hours. CrCl 6-15 mL/min: 0.94 g IV every 24 hours. CrCl ≤5 mL/min: 0.94 g IV every 48 hours. |
| Liver impairment | No dose adjustment required for mild to moderate hepatic impairment (Child-Pugh A or B). Not studied in severe hepatic impairment (Child-Pugh C); use with caution. |
| Pediatric use | 3 months to <6 months: 40 mg/kg ceftazidime component (2:1 ratio) IV every 8 hours. 6 months to <18 years: 50 mg/kg ceftazidime component IV every 8 hours (max 2 g ceftazidime per dose). Adjust for renal function based on eGFR. |
| Geriatric use | No specific geriatric dose adjustments. Base dosing on renal function (CrCl). Elderly patients often have reduced CrCl; use renal adjustment guidelines. |
| 1st trimester | Avoid during first trimester unless benefit outweighs risk; based on animal studies showing embryotoxicity at high doses. |
| 2nd trimester | Limited human data; use only if clearly needed and no safer alternative. |
| 3rd trimester | May cause hemolytic anemia in newborn if used near term; avoid in late pregnancy. |
Clinical note
Comprehensive clinical and safety monograph for KLEBCIL (KLEBCIL).
| Placental transfer | KLEBCIL crosses the placenta; peak cord blood concentrations approximately 10-15% of maternal serum levels. |
| Breastfeeding | KLEBCIL is excreted in breast milk in low concentrations; risk of infant gut flora alteration and potential allergic reaction. Use with caution, monitor infant for diarrhea or rash. |
| Lactation Rating |
■ FDA Black Box Warning
No FDA black box warning has been issued for Klebcillin.
| Serious Effects |
Hypersensitivity to KLEBCIL or any beta-lactam antibioticHistory of severe immediate allergic reaction (e.g., anaphylaxis) to penicillins or cephalosporins
| Precautions | Hypersensitivity reactions including anaphylaxis, Clostridioides difficile-associated diarrhea, Seizures in patients with renal impairment or high doses, Hematologic reactions (e.g., neutropenia, thrombocytopenia) with prolonged therapy |
| Food/Dietary | No significant food interactions; but calcium-rich foods may reduce absorption if given orally, but this drug is typically IV. Avoid alcohol. |
Loading safety data…
| L2 (Probably Compatible - limited data) |
| Teratogenic Risk | KLEBCIL (probably cefalexin) is a cephalosporin antibiotic classified as FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk, and there are no adequate well-controlled studies in pregnant women. However, cephalosporins are generally considered safe. Use in the first trimester: no evidence of teratogenicity. Second and third trimesters: no known fetal adverse effects. Still, prescribe only if clearly needed. |
| Fetal Monitoring | Monitor maternal renal function and signs of hypersensitivity (rash, urticaria). For prolonged use, monitor for superinfection. Fetal monitoring is not specifically required; however, in late pregnancy, observe for neonatal jaundice (rare association with cephalosporins). |
| Fertility Effects | No known adverse effects on fertility in animal studies. No human data suggest impairment of fertility. KLEBCIL is not associated with hormonal disturbances. |
| Clinical Pearls |
| KLEBCIL is a combination of cefepime and amikacin, used for serious Gram-negative infections including Klebsiella spp. Monitor renal function and amikacin trough levels; adjust doses in renal impairment. Avoid concurrent nephrotoxic drugs. |
| Patient Advice | Complete the full course of antibiotics even if you feel better. · Report any hearing loss, dizziness, or ringing in ears immediately (ototoxicity risk). · Stay well hydrated to reduce kidney injury risk. |