Cefpodoxime
Indications
Cefpodoxime is used for:
Pharyngitis, Acute otitis media, Community-acquired pneumonia, Sinusitis, UTI, Cystitis, Gonorrhea, Skin and skin structure infections, Tonsillitis, Respiratory tract infections, Acute Maxillary Sinusitis, Acute bacterial exacerbation of chronic bronchitis
Adult Dose
Acute Bronchitis & Acute Exacerbations of Chronic Bronchitis, Acute Maxillary Sinusitis
200 mg PO q12hr for 10 days
Acute Community-Acquired Pneumonia
200 mg PO q12hr for 14 days
Pharyngitis/Tonsillitis
100 mg PO q12hr for 5-10 days
Skin/Skin Structure Infections
400 mg PO q12hr for 7-14 days
Uncomplicated gonorrhoea
200 mg as a single dose
Uncomplicated Urinary Tract Infections
100 mg PO q12hr for 7-14 days
Hepatic impairment
Dosage adjustment not necessary
Child Dose
Child : PO 10 mg/kg/day, max 400 mg/day q12h
6 months - 2 years : 40 mg every 12 hours
3 - 8 years : 80 mg every 12 hours
over 9 years : 100 mg every 12 hours
Renal Dose
Renal impairment: Patients on haemodialysis: Dose should be given after each dialysis session.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hrly.
<10 Increase dosing intervals to 48 hrly.
Administration
Should be taken with food. Take after meals.
Reconstitution: Reconstitute powd for oral susp at the time of dispensing by adding the amount of water specified on the container to provide a susp containing 50 mg or 100 mg per 5 mL. Add water in 2 equal parts and shake the bottle vigorously after each addition.
Contra Indications
Hypersensitivity.
Precautions
History of allergy to penicillin; severe renal impairment; pregnancy and lactation.
Lactation: Drug excreted in breast milk in low concentrations; not recommended
Pregnancy-Lactation
Pregnancy category: B
Lactation: Drug excreted in breast milk in low concentrations; not recommended
Interactions
Antacids or H2-blockers may decrease the absorption of cefpodoxime. Probenecid inhibits renal excretion.
Potentially Fatal: Monitor renal function during admin. Additive nephrotoxic effects with furosemide.
Adverse Effects
Side effects of Cefpodoxime :
>10%
Diarrhea in infants and toddlers (15.4%), Diaper rash (12.1%)
1-10%
Diarrhea (7.4%), Nausea (3.8%), Vaginal infection (3.1%), Vomiting (1.1-2.1%), Abdominal pain (1.6%), Rash (1.4%), Headache (1.1%)
Potentially Fatal: Pseudomembranous colitis; nephrotoxicity.
Mechanism of Action
Cefpodoxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.