Cefpodoxime

General

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

Adult Dosing

• Bronchitis (chronic), actue bacterial infection: 200 mg q 12 h for 10 days
• Pharyngitis/Tonsillitis: 100 mg q 12 h for 5-10 days
• Acute community acquired pneumonia: 200 mg q 12 h for 14 days
• Acute rhino sinusitis: 200 mg q 12 h for 10 days
• Skin and soft tissue infection: 400 mg q 12 h for 14 days
• Urinary tract infection, uncomplicated: 100 mg q 12 h for 7 days

Pediatric Dosing

• General range
  • Infant ≥2 months to children <12 years: 10 mg/kg/day (maximum 200 mg/dose) q 12 h
  • Children >12 years to adolescent: 100 to 400 mg 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 200 mg/dose) q 12 h for 5 days, duration according to AAP recommendation : 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 100 mg/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 200 mg/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)
    • 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

Adverse Reactions

Serious (<1%)

• Anaphylaxis
• Hypotension
• Nephritis
• Pseudomembranous colitis

Common

• Diaper rash
• Diarrhoea
• Nausea/vomiting
• Abdominal pain

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)