cefpodoxime

Cefpodoxime is a broad spectrum third-generation cephalosporin antibiotic used to treat a wide variety of bacterial infections. Cefpodoxime is effective against many strains of gram-negative and gram-positive bacteria including some strains that develop resistance to earlier generations of cephalosporins. Gram-negative and gram-positive bacteria are structurally different, and the types are identified by whether the bacteria get dyed or not in the Gram stain lab test.

Cefpodoxime kills bacteria (bactericidal) by inhibiting the synthesis of peptidoglycan, a vital constituent that provides stability to the bacterial cell wall. Cephalosporins are beta-lactam antibiotics that contain a beta-lactam ring in their chemical structure. Beta-lactam is a compound that targets and blocks penicillin-binding proteins, enzymes that are essential for the biosynthesis of peptidoglycan.

Some bacteria develop resistance to beta-lactam antibiotics by producing beta-lactamases, enzymes that cleave the beta-lactam rings in the antibiotics and destroy them. Cefpodoxime is effective for several bacterial strains despite the presence of beta-lactamases.

The brand Vantin has been discontinued in the USA, however, generic cefpodoxime is available.

Cefpodoxime is used to treat the following bacterial infections:

Adult

• Acute bronchitis and acute exacerbations of chronic bronchitis
• Acute community-acquired pneumonia
• Acute maxillary sinusitis
• Pharyngitis/tonsillitis
• Skin and skin structure infections
• Gonorrhea
• Urinary tract infections

Pediatric

• Acute maxillary sinusitis
• Acute otitis media (middle ear infection)
• Pharyngitis/tonsillitis
• Chronic bacterial bronchitis exacerbation
• Acute uncomplicated cystitis (bladder infection)
• Acute community-acquired pneumonia

Organisms susceptible to cefpodoxime include:

• Gram-positive bacteria: Staphylococcus aureus (methicillin-susceptible strains, including those producing penicillinases), Staphylococcus saprophyticus, Streptococcus pneumoniae (excluding penicillin-resistant isolates), Streptococcus pyogenes
• Gram-negative bacteria: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae (including beta-lactamase producing isolates), Moraxella catarrhalis, Neisseria gonorrhoeae (including penicillinase-producing isolates)

• Do not take cefpodoxime if you are hypersensitive to cefpodoxime or cephalosporin group of antibiotics.
• Use cefpodoxime with caution in patients with a history of penicillin allergy or beta-lactam allergy.
• Bacterial and fungal overgrowth of non-susceptible organisms may occur with prolonged or repeated treatment with cefpodoxime.
• Use of nearly all antibacterial agents including cefpodoxime can cause Clostridium difficile overgrowth and associated diarrhea or colitis.

Common side effects of cefpodoxime include:

• Gastrointestinal effects including:
  • Nausea
  • Vomiting
  • Diarrhea and loose stools
  • Abdominal pain
  • Abdominal distention
  • Indigestion (dyspepsia)
  • Gas (flatulence)
  • Constipation
  • Loss of appetite (anorexia)
• Vulvovaginal fungal (yeast) infections
• Bacterial infections
• Parasitic infections
• Diaper rash in infants
• Headache
• Malaise
• Fatigue
• Lack of energy (asthenia)
• Fever
• Chest pain
• Back pain
• Generalized pain
• Muscle pain (myalgia)
• Migraine
• Chills
• Abscess
• Allergic reactions such as:
  • Rash
  • Hives (urticaria)
  • Itching (pruritus)
  • Fungal dermatitis
• Congestive heart failure
• Palpitations
• High or low blood pressure (hypertension or hypotension)
• Asthma
• Shortness of breath (dyspnea)
• Cough
• Nasal bleeding (epistaxis)
• Dry mouth
• Taste alteration or loss
• Ringing in the ears (tinnitus)
• Dizziness
• Vertigo
• Insomnia
• Nightmares
• Impaired concentration
• Anxiety
• Blood in urine (hematuria)
• Painful urination (dysuria)
• Urinary frequency
• Penile infection
• Vaginal pain
• Uterine bleeding between periods (metrorrhagia)

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Oral Suspension

• 50 mg/5 mL
• 100 mg/5 mL

Tablet

• 100 mg
• 200 mg

Adult

Acute Bronchitis and Acute Exacerbations of Chronic Bronchitis

• 200 mg orally every 12 hours for 10 days

Acute Community-Acquired Pneumonia

• 200 mg orally every 12 hours for 14 days

Acute Maxillary Sinusitis

• 200 mg orally every 12 hours for 10 days

Pharyngitis/Tonsillitis

• 100 mg orally every 12 hours for 5-10 days

Skin/Skin Structure Infections

• 400 mg orally every 12 hours for 7-14 days

Gonorrhea

• Uncomplicated gonorrhea in men and women; rectal gonococcal infections in women
• 200 mg orally once

Uncomplicated Urinary Tract Infections

• 100 mg orally every 12 hours for 5-7 days

Complicated urinary tract infections, including pyelonephritis

• 200 mg orally every 12 hours

Dosing Modifications

Renal impairment

• Creatinine clearance under 30 ml/min: give every 24 hours
• Hemodialysis: give 3 times weekly after dialysis

Hepatic impairment

• Dosage adjustment is not necessary

Pediatric

General Dosage Range

• Infants under 2 months: safety and efficacy not established
• Infants 2 months – Children 12 years of age: 5 mg/kg orally every 12 hours; individual doses not to exceed 200 mg
• Children above 12 years: 100 to 400 mg orally every 12 hours

Acute Maxillary Sinusitis

• Infants under 2 months: safety and efficacy not established
• Infants 2 months – Children 12 years of age: 5 mg/kg orally every 12 hours for 10 days; individual doses not to exceed 200 mg
• Children above 12 years: 200 mg orally every 12 hours for 10 days

Acute Otitis Media

• Infants under 2 months: safety and efficacy not established
• Infants 2 months – Children 12 years of age: 5 mg/kg orally every 12 hours for 10 days; individual doses not to exceed 200 mg
• Children above 12 years: 200 mg orally every 12 hours for 10 days

Pharyngitis/Tonsillitis

• Infants under 2 months: safety and efficacy not established
• Infants 2 months – Children 12 years of age: 5 mg/kg orally every 12 hours for 5-10 days; individual doses not to exceed 100 mg
• Children above12 years: 100 mg orally every 12 hours for 5-10 days
• Chronic bacterial bronchitis exacerbation
• Children above 12 years: 200 mg orally every 12 hours for 10 days

Acute uncomplicated cystitis

• Children above 12 years: 100 mg orally every 12 hours for 5-7 days

Acute Community-Acquired Pneumonia

• 200 mg orally every 12 hours for 14 days

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

Cefpodoxime has no known severe interactions with other drugs.

Serious interactions of cefpodoxime include:

• argatroban
• BCG vaccine live
• bivalirudin
• cholera vaccine
• dalteparin
• enoxaparin
• fondaparinux
• heparin
• lepirudin
• warfarin

Cefpodoxime has moderate interactions with 28 different drugs.

Minor interactions of cefpodoxime include:

• ceftibuten
• ceftizoxime
• choline magnesium trisalicylate
• furosemide
• rose hips
• Willow bark

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Cefpodoxime may be acceptable for use in pregnancy. There are no adequate and controlled studies for use in pregnant women and the drug should be used only if clearly needed.
• Cefpodoxime has not been studied for use during labor and delivery and should be used only if clearly needed.
• Cefpodoxime is excreted into breast milk in low concentrations; it is not recommended for nursing mothers.