Adult Dosing
Respiratory tract infections (including pharyngitis and tonsillitis)
- 100 mg PO bid x 5-10 days
Community-acquired pneumonia
Acute bacterial exacerbations of chronic bronchitis
Skin and skin structure infections
- 400 mg PO bid x 7-14 days
Uncomplicated urinary tract infections
Uncomplicated gonorrhoea (men and women) and rectal gonococcal infections (women)
- 200 mg PO as a single dose [CDC recommends a single 400-mg dose]
Disseminated gonococcal infection
- 400 mg PO bid x at least 7 days [CDC recommendation; not FDA approved]
Acute maxillary sinusitis
Note:
- Give tablets with food to enhance absorption
Pediatric Dosing
- Safety and efficacy in infants <2 months of age have not been established
Respiratory tract infections (including pharyngitis and tonsillitis)
- Children 2 mo-12 yrs: 10 mg/kg/day PO divided bid x 5-10 days [Max: 200 mg/day]
- Children
12 yrs: 100 mg PO bid x 5-10 days
Community acquired pneumonia
- Children 12 yrs: 200 mg PO bid x 14 days
Acute bacterial exacerbations of chronic bronchitis
- Children 12 yrs: 200 mg PO bid x 10 days
Skin and skin structure infections
- Children 12 yrs: 400 mg PO bid x 7-14 days
Uncomplicated urinary-tract infections
- Children 12 yrs: 100 mg PO bid x 7 days
Uncomplicated gonorrhoea (men and women) and rectal gonococcal infections (women)
- Children 12 yrs: 200 mg PO as a single dose [CDC recommends a single 400-mg dose]
- Children 8 yrs (45 kg): 400 mg PO as a single dose [Recommended by the American Academy of Pediatrics]
Disseminated gonococcal infection
- Children 12 yrs: 400 mg PO bid x at least 7 days [CDC recommendation; not FDA approved]
Acute maxillary sinusitis
- Children 2 mo-12 yrs: 10 mg/kg/day PO divided bid x 10 days [Max: 400 mg/day]
- Children 12 yrs: 200 mg PO bid x 10 days
Acute otitis media
- Children 2 mo-12 yrs: 10 mg/kg/day PO divided bid x 5 days [Max: 400 mg/day]
Note:
- Give tablets with food to enhance absorption
[Outline]
Renal Dose Adjustment: (Based on CrCl)
- CrCl <30 mL/min: Increase the dosing interval to qd instead of bid
- Hemodialysis: Give dose 3 times/week following dialysis
Hepatic Dose Adjustment:
- Hepatic impairment: No dose adjustments
See Supplemental Patient Information
- Carefully inquire regarding previous hypersensitivity reactions to cefpodoxime, penicillins, other cephalosporins, or other drugs prior to initiating cefpodoxime therapy. Suspend therapy on occurrence of any allergic reactions and initiate appropriate medical therapy. Manage serious anaphylactic reactions with immediate treatment using epinephrine, oxygen, intravenous fluids and antihistamine, and airway management, including intubation, as indicated
- Administer therapy with extreme caution in penicillin sensitive patients, as cross reactivity among beta-lactam antibiotics has been reported and may occur in up to 10% of patients with a history of penicillin allergy
- Clostridium difficile associated diarrhea (CDAD), which may vary in severity from mild diarrhea to fatal colitis, has been reported with use of cefpodoxime. Consider this diagnosis in patients presenting with diarrhea following administration of antibiotics and initiate therapeutic measures on confirmation of diagnosis. Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridium. Discontinue therapy to manage mild cases; in moderate to severe cases, consider management of fluids and electrolytes, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation
- The total daily dose of cefpodoxime should be reduced in patients with renal impairment because high and prolonged serum antibiotic concentrations may occur in such patients following usual doses. Administer cautiously in patients receiving concurrent treatment with potent diuretics
- Use of therapy in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication may increase the risk of the development of drug-resistant bacteria
- Prolonged use may result in overgrowth of nonsusceptible organisms; monitor continuously. Discontinue therapy on occurrence of superinfection due to bacteria or fungi and institute appropriate measures
Cautions: Use cautiously in
- Renal impairment
- Hypersensitivity to penicillin
- Hx of recent antibiotic-associated colitis
- Seizure disorder
- Concurrent nephrotoxic agents
Supplemental Patient Information
- Advise patients to contact their physicians if severe watery or bloody diarrhea develops during therapy or even as late as two or more months after having taken the last dose of antibiotic
Pregnancy Category:B
Breastfeeding: No information is available regarding cefpodoxime use during breastfeeding. However, cephalosporins are generally not expected to cause adverse effects in breastfed infants and are considered safe during breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 3 January 2011). Manufacturer advises caution.
