Cefpodoxime + Clavulanic Acid

Indications

Cefpodoxime + Clavulanic Acid 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, Enteric fever

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 200-400 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 Complicated urinary tract infections 200 mg PO 12 hourly for 7 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.

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

Interactions

Antacids or H2-blockers may decrease the absorption of cefpodoxime. Reduced renal excretion w/ probenecid.

Adverse Effects

Side effects of Cefpodoxime + Clavulanic Acid : >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. Addition of clavulanate inhibits beta-lactamase-producing bacteria; Clavulanic acid has a high affinity for and binds to certain ?-lactamases that generally inactivate Cefpodoxime by hydrolyzing its ?-lactam ring. Combining clavulanate potassium with Cefpodoxime extends the antibacterial spectrum of Cefpodoxime to include many bacteria normally resistant to Cefpodoxime and other penicillins and cephalosporins.