Cefpodoxime proxetil is an oral third generation cephalosporin like cefixime and ceftibuten that inhibits bacterial cell wall synthesis. It is used to treat the following infections:

• Treatment of acute bacterial exacerbation of Chronic bronchitis caused by:

  • Streptococcus pneumoniae
  • Non-betalactamase- producing strains of Haemophilus influenzae
  • Moraxella catarrhalis.

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• Treatment of acute uncomplicated Cystitis caused by:

  • Escherichia coli
  • Klebsiella pneumoniae
  • Proteus mirabilis
  • Staphylococcus saprophyticus.

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• Treatment of Gonorrhea: (It is no longer recommended for gonorrheal infections because of resistance to the drug).

  • Acute and uncomplicated infections in women in the anorectal area
  • Acute and uncomplicated urethral and cervical gonorrhea.

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• Treatment of acute Otitis media caused by:

  • S. pneumoniae excluding penicillin-resistant strains
  • Streptococcus pyogenes
  • H. influenzae including beta-lactamase producing strains
  • M. catarrhalis including beta-lactamase producing strains.

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• Treatment of Pharyngitis or tonsillitis caused by:

  • Strep. pyogenes.

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• Treatment of community-acquired pneumonia caused by:

  •  S. pneumoniae
  • H. influenzae including beta-lactamase-producing strains.

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• Treatment of acute bacterial rhinosinusitis ( in combination with clindamycin) caused by:

  • H. influenzae including beta-lactamase producing strains
  • S. pneumoniae
  • M. catarrhalis.

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• Treatment of uncomplicated skin and soft tissue infections caused by:

  • S. aureus including penicillinase-producing strains
  • S. pyogenes.

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• Off label Use of Cefpodoxime in Adults include:

  • Complicated Urinary tract infections including pyelonephritis.

Cefpodoxime proxetil dose in Adults:

• Acute bacterial exacerbation of chronic Bronchitis:

  • 200 mg orally twice daily for 10 days.

• Use in the treatment of community-acquired Pneumonia (in combination with a macrolide or doxycycline):

200 mg orally twice daily for 14 days.

• A duration of 5 - 7 days may be used when it is used with a macrolide or doxycycline).

• Use for treating acute bacterial Rhinosinusitis as an alternative agent:

  • For 5–7 days, take 200 mg twice day by mouth.
  • It may be combined with clindamycin if pneumococcal resistance is suspected.

• Use in the treatment of Skin and soft tissue infections:

  • 400 mg orally twice daily for 7 - 14 days.

• Use in the treatment of Group A Streptococcal pharyngitis:

  • 100 mg orally twice daily for 5 - 10 days.

• Use as an alternative agent in the treatment of Urinary tract infection:

  • Use in the treatment of acute uncomplicated Cystitis:
    • 100 mg orally twice daily for 5 - 7 days.
  • Off label use in the treatment of complicated UTI including pyelonephritis:
    • 200 mg orally twice daily for 10 - 14 days.

Cefpodoxime proxetil Dose in children:

• General dosing of Cefpodoxime in susceptible infection in mild to moderate infections:
  • Infants, Children, and Adolescents:
    • 5 mg/kg/dose orally twice daily to the usual maximum dose of 200 mg/dose.
    • Dose up to 400 mg/dose may be required for some types of infection in children older than 12 years of age.

• Use in treatment of bacterial exacerbation of Chronic Bronchitis:

  • Children older than 12 years and Adolescents:
    • 200 mg orally twice daily for 10 days

• Use in the treatment of acute Otitis media:

  • Infants and Children 2 months to 12 years of age:
    • 5 mg/kg/dose orally twice daily to a maximum dose of 200 mg/dose for 5 or more days.
  • According to the AAP guidelines, the duration of treatment is based on the patients age:
    • If less than 2 years of age or severe symptoms:
      • 10-days course
    • If 2 - 5 years of age with mild to moderate symptoms:
      • 7-days course
    • If older than 6 years of age with mild to moderate symptoms:
      • 5 - 7-days course.

• Use in the treatment of Pharyngitis & tonsillitis:

  • Infants older than 2 months and Children less than 12 years of age:
    • 5 mg/kg/dose orally twice daily for 5 - 10 days to a maximum dose of 100 mg/dose.
  • Children older than 12 years and Adolescents:
    • 100 mg orally twice daily for 5 to 10 days.

• Use in the treatment of acute community-acquired Pneumonia:

  • Infants older than 3 months and Children less than12 years:
    • 5 mg/kg/dose orally twice daily to a maximum dose of 200 mg/dose.
  • Children older than 12 years and Adolescents:
    • 200 mg orally twice daily for 14 days.

• Use in treatment of acute maxillary Rhinosinusitis (in combination with clindamycin):

  • Infants older than 2 months and Children less tha 12 years:
    • 5 mg/kg/dose orally twice daily for 10 days to a maximum dose of 200 mg/dose.
  • Children older than 12 years and Adolescents:
    • 200 mg orally twice daily for 10 days.

• Use in treatment of Skin and skin structure:

  • Children older than 12 years and Adolescents:
    • 400 mg orally twice daily for 7-14 days.

• Use in treatment of uncomplicated Urinary tract infection:

  • Children older than 12 years and Adolescents:
    • 100 mg orally twice daily for 7 days.

Pregnancy Risk Factor B

• Cefpodoxime is safe to be used during pregnancy to treat susceptible infections.

Cefpodoxime use during breastfeeding:

• Breastmilk contains cefpodoxime.
• Cefpodoxime treatment should not be administered to mothers who are breastfeeding.
• The child should be monitored for any gastrointestinal problems during its use.

Cefpodoxime dose in patients with renal disease:

• CrCl of 30 mL/minute or more:
  • Dosage adjustment is not needed.
• CrCl of less than 30 mL/minute:
  • Administer the dose once a day.
• Hemodialysis:
  • Administer the dose thrice weekly after dialysis.

Cefpodoxime proxetil Dose in liver disease:

Dosage adjustment in patients with liver disease is not recommended.

Common Side Effects Of Cefpodoxime Include:

• Dermatologic:
  • Diaper rash
• Gastrointestinal:
  • Diarrhea

Less Common Side Effects Of Cefpodoxime Include:

• Central nervous system:
  • Headache
• Dermatologic:
  • Skin rash
• Gastrointestinal:
  • Diarrhea
  • Nausea
  • Abdominal pain
  • Vomiting
• Genitourinary:
  • Vaginal infection

Contraindication to Cefpodoxime include:

• Cefpodoxime, other cephalosporins, or any ingredient in this formulation allergy reactions

Warnings and Precautions

• Allergy to Betalactam
  • Patients who have a history IgE-mediated reactions such as anaphylaxis, urticaria, or angioedema should be cautious about taking beta-lactam allergy medication.

• Superinfection
  • Cefpodoxime therapy for longer periods (over 2 months) can lead to superinfections, including fungal or bacterial superinfections. C. difficile-associated diarrhea, (CDAD), and pseudomembranous collitis can occur.

• Renal impairment
  • Patients with impaired renal function should be cautious when taking the drug. Adjusting the dose may be necessary.

Cefpodoxime: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitor:

• Renal function
• During the initial dose, keep an eye out for anaphylactic symptoms

How to take Cefpodoxime?

• It is administered orally round the clock with food.
• The suspension should be shaken well before use and may be administered without regard to meals.

Mechanism of action of Cefpodoxime:

Cefpodoxime

• An oral third-generation cephalosporin, which inhibits the formation proteins and peptidoglycans.
• It binds to penicillin-binding proteins, eventually leading to cell lysis through the use of autolytic enzymes.

It has the ability to enter tissues, including the pleural cavity, tonsils, and lungs.

The drug accounts for about 1/3 of all prescriptions.Plasma proteins boundIt is. It isMetabolizedIt is found in the gastrointestinal tract, and 50% bio-available following oral administration. It has been ahalf-life eliminationPatients with severe renal impairment (CrCl less than 30ml/min) may require a prolonged period of 2 to 3 hours. Peak timePlasma concentrations after oral administration of the tablets are 2 - 3 hours.

This is slower if it is taken with food. Around 30% of the drug's total value isexcretedThe urine will remain unchanged for 12 hours. 

Cefpodoxime brands (international):

• Auropodox
• Banadoz
• Banan
• Banan Dry Syrup
• Biocef
• Cefadox
• Cefdox
• Cefdoxime
• Cefirax
• Cefodox
• Cefpotek
• Cefubi-100 DT
• Ceodox
• Cepodem
• Cepox
• Daedox
• Doxcef
• Forexo
• Froxtil
• Leprox
• Leprox-DS
• Maxispect
• Monocrin
• Necpod
• Orelox
• Otreon
• Podacef
• Podomexef
• Rexocef
• Swich
• Thirgecef
• Trefpod
• Trizef
• Zudem

Cefpodoxime brands in Pakistan: