Cefpodoxime

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General

  • Type: 3rd generation cephalosporin
  • Dosage Forms: tablet (100,200), suspension (50mg/5ml, 100mg/5ml)
  • Common Trade Names: Cefopodoxine Proxetil

Adult Dosing

Bronchitis (chronic)

  • 200mg q 12 h for 10 days

Acute bacterial infection

  • 200mg q 12 h for 10 days

Pharyngitis/Tonsillitis

  • 100mg q 12 h for 5-10 days

Acute community acquired pneumonia

  • 200mg q 12 h for 14 days

Acute rhino sinusitis

  • 200mg q 12 h for 10 days

Skin and soft tissue infection

  • 400mg q 12 h for 14 days

Urinary tract infection, uncomplicated

  • 100mg q 12 h for 7 days

Pediatric Dosing

General

  • Infant ≥2 months to children <12 years: 10mg/kg/day (maximum 200mg/dose) q 12 h
  • Children >12 years to adolescent: 100 to 400mg q 12 h

Specific indication

  • Bronchitis (chronic), acute bacterial infection
    • Adult dosing for Infant ≥2 months to children <12 years
  • Acute otitis media
    • Infant ≥2 months to children <12 years: 5mg/kg/dose (maximum 200mg/dose) q 12 h for 5 days, duration according to AAP recommendation [1]: for children < 2 years or any age with sever symptoms; 10 day-course, age 2-**5 years with mild to moderate symptoms: 7 day-course; age ≥ 6 years with mild to moderate symptoms: 5 day-course
  • Pharyngitis/tonsillitis:
    • Infant ≥2 months to children <12 years: 5mg/kg/dose (maximum 100mg/dose) q 12 h for 5-10 days
    • Children >12 years to adolescent: adult dosing
  • Acute sinusitis
    • Infant ≥2 months to children <12 years: 5mg/kg/dose (maximum 200mg/dose) q 12 h for 10 days, ISDA recommend adding Clindamycin for 10-14 days in patients with failed initial therapy or at risk of antibiotic resistance (attending daycare, age <2 years, recently hospitalised, antibiotic used with in 1 month) [2]
    • Children >12 years to adolescent: adult dosing
  • Skin soft tissue infection and uncomplicated urinary tract infection
    • Children >12 years to adolescent: adult dosing

Special Populations

  • Pregnancy Rating: B
  • Lactation: excreted in breast milk, not recommended for nursing women
  • Renal Dosing
    • Adult
      • CrCl >30 mL/minute: dosage adjustment not needed
      • CrCl <30 mL/minute: administer q 24 h
      • Hemodialysis: 3 times/week following dialysis
    • Pediatric: not defined
  • Hepatic Dosing: dosage adjustment not nescessary

Contraindications

  • Allergy to class/drug
  • Caution:
    • Hypersensitivity to [[penicillin]
    • Renal impairment
    • Concurrent nephrotoxic agent
    • Seizure disorder
    • Recent antibiotic-associated colitis

Adverse Reactions

Serious (<1%)

Common

Pharmacology

  • Half-life: 2-3 h, prolonged to ~10 h if CrCl <30 mL/minute
  • Metabolism: De-esterified in GI tract to active metabolite
  • Excretion: Urine
  • Mechanism of Action: Inhibit bacterial cell walls synthesis (binding to penicillin-binding proteins (PBPs)

See Also

References

  1. Lieberthal A. et al.The Diagnosis and Management of Acute Otitis Media.Pediatrics Mar 2013, 131 (3) e964-e999
  2. Chow AW et.al. ISDA clinical practice guideline for acute bacterial rhino sinusitis in children and adult.Clinical Infect Dis.2012 Apr;54(8):e72-e112