Cefpodoxime: Difference between revisions

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


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


==Pediatric Dosing==
==Pediatric Dosing==
*General range  
*General range  
**Infant ≥2 months to children <12 years: 10 mg/kg/day (maximum 200 mg/dose) q 12 h
**Infant ≥2 months to children <12 years: 10mg/kg/day (maximum 200mg/dose) q 12 h
**Children >12 years to adolescent: 100 to 400 mg q 12 h  
**Children >12 years to adolescent: 100 to 400mg q 12 h  
*Specific indication
*Specific indication
**Bronchitis (chronic), acute bacterial infection: adult dosing for Infant ≥2 months to children <12 years
**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 <ref>Lieberthal A. et al.The Diagnosis and Management of Acute Otitis Media.Pediatrics Mar 2013, 131 (3) e964-e999</ref>: 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
**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 <ref>Lieberthal A. et al.The Diagnosis and Management of Acute Otitis Media.Pediatrics Mar 2013, 131 (3) e964-e999</ref>: 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:
**Pharyngitis/tonsillitis:
***Infant ≥2 months to children <12 years: 5mg/kg/dose (maximum 100 mg/dose) q 12 h for 5-10 days
***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  
***Children >12 years to adolescent: adult dosing  
**Acute sinusitis
**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) <ref>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</ref>
***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) <ref>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</ref>
***Children >12 years to adolescent: adult dosing
***Children >12 years to adolescent: adult dosing
***skin soft tissue infection and uncomplicated urinary tract infection: children >12 years to adolescent: adult dosing
***skin soft tissue infection and uncomplicated urinary tract infection: children >12 years to adolescent: adult dosing

Revision as of 08:30, 20 July 2016

General

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

Adult Dosing

  • Bronchitis (chronic), actue 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 range
    • 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

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)

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
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