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, oral suspension
*Common Trade Names: Cefopodoxine Proxetil
*Dosage Strengths: tablet: 100mg, 200mg; oral suspension: 50mg/5mL, 100mg/5mL
*Routes of Administration: PO
*Common Trade Names: Cefopodoxine Proxetil, Vantin


==Adult Dosing==
==Adult Dosing==
*Bronchitis (chronic), actue bacterial infection: 200 mg q 12 h  for 10 days
===[[Bronchitis]] (chronic)===
*Pharyngitis/Tonsillitis: 100 mg q 12 h for 5-10 days
*200mg q 12 h  for 10 days
*Acute community acquired pneumonia: 200 mg q 12 h for 14 days
===Acute bacterial infection===
*Acute rhino sinusitis: 200 mg q 12 h for 10 days
*200mg q 12 h  for 10 days
*Skin and soft tissue infection: 400 mg q 12 h for 14 days
===[[Pharyngitis]]/Tonsillitis===
*Urinary tract infection, uncomplicated: 100 mg q 12 h for 7 days
*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==
==Pediatric Dosing==
*General range
===General===
**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
**Acute otitis media: Infant ≥2 months to children <12 years: 5 mg/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
**Adult dosing for Infant ≥2 months to children <12 years
**Pharyngitis/tonsillitis:
*[[Acute otitis media]]
***Infant ≥2 months to children <12 years: 5 mg/kg/dose (maximum 100 mg/dose) q 12 h for 5-10 days
**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
***Children >12 years to adolescent: adult dosing  
*[[Pharyngitis]]/tonsillitis:
**Acute sinusitis
**Infant ≥2 months to children <12 years: 5mg/kg/dose (maximum 100mg/dose) q 12 h for 5-10 days
***Infant ≥2 months to children <12 years: 5 mg/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>
**Children >12 years to adolescent: adult dosing  
***Children >12 years to adolescent: adult dosing
*Acute [[sinusitis]]
***skin soft tissue infection and uncomplicated urinary tract infection: children >12 years to adolescent: adult dosing
**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
*Skin soft tissue infection and uncomplicated [[urinary tract infection]]
**Children >12 years to adolescent: adult dosing


==Special Populations==
==Special Populations==
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==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*Caution:
**Hypersensitivity to [[penicillin]
**Renal impairment
**Concurrent nephrotoxic agent
**[[Seizure]] disorder
**Recent antibiotic-associated [[colitis]]


==Adverse Reactions==
==Adverse Reactions==
===Serious (<1%)===  
===Serious (<1%)===
*Anaphylaxis  
*[[Anaphylaxis]]
*Hypotension
*[[Hypotension]]
*Nephritis
*Nephritis
*Pseudomembranous colitis
*Pseudomembranous colitis
*[[Seizures]]
*[[Leukopenia]]
*[[Thrombocytopenia]]
*[[Anemia]]
*Exfoliative dermatitis
*[[Stevens-Johnson Syndrome]]
*C. diff associated [[diarrhea]]
===Common===
===Common===
*Diaper rash
*Diaper rash
*Diarrhoea
*[[Diarrhea]]
*Nausea/vomiting  
*[[Nausea]]/[[vomiting]]
*Abdominal pain
*[[Abdominal pain]]
*Dyspepsia
*[[Headache]]
*[[Candidiasis]], vulvovaginal


==Pharmacology==
==Pharmacology==
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==See Also==
==See Also==


==Sources==


==References==
<references/>
<references/>
[[Category:Pharmacology]]
 
[[Category:Pharmacology]] [[Category:ID]]

Latest revision as of 21:57, 19 September 2019

General

  • Type: 3rd generation cephalosporin
  • Dosage Forms: tablet, oral suspension
  • Dosage Strengths: tablet: 100mg, 200mg; oral suspension: 50mg/5mL, 100mg/5mL
  • Routes of Administration: PO
  • Common Trade Names: Cefopodoxine Proxetil, Vantin

Adult Dosing

Bronchitis (chronic)

  • 200mg q 12 h for 10 days

Acute 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

  • 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
  • Caution:
    • Hypersensitivity to [[penicillin]
    • Renal impairment
    • Concurrent nephrotoxic agent
    • Seizure disorder
    • Recent antibiotic-associated colitis

Adverse Reactions

Serious (<1%)

Common

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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