Cefpodoxime

Oral
Acute otitis media

Oral
Skin and soft tissue infections

Oral
Respiratory tract infections, Urinary tract infections

Oral
Uncomplicated gonorrhoea

Patient on haemodialysis: Dose should be given after each dialysis session.

CrCl (mL/min)	Dosage
<10	Increase dosing intervals to 48 hrly.
10-39	Increase dosing intervals to 24 hrly.

Should be taken with food.

Reconstitute powd for oral susp at the time of dispensing by adding the amount of water specified on the container to provide a susp containing 50 mg or 100 mg per 5 mL. Add water in 2 equal parts and shake the bottle vigorously after each addition.

Hypersensitivity to cefpodoxime or other cephalosporins.

Patient w/ history of penicillin allergy. Renal impairment. Childn. Pregnancy and lactation.

Diarrhoea, nausea, abdominal pain, vomiting, diaper and skin rash, headache, vag infection. Anxiety, chest pain, cough, decreased appetite, dizziness, dysgeusia, epistaxis, eye pruritus, fatigue, fever, flatulence, flushing, fungal skin infection, hypotension, insomnia, malaise, nightmares, pruritus, purpuric nephritis, tinnitus, weakness, xerostomia, vulvovaginal candidiasis.
Potentially Fatal: Anaphylaxis, Clostridium difficile-associated diarrhoea and colitis.

PO: B

Monitor renal function; observe for signs and symptoms of anaphylaxis during 1st dose.

Symptoms: Nausea, vomiting, epigastric distress and diarrhoea. Management: Haemodialysis or peritoneal dialysis may be useful in the event of a serious toxic reaction particularly if renal function is compromised.

Antacids or H₂-blockers may decrease the absorption of cefpodoxime. Reduced renal excretion w/ probenecid.

Cefpodoxime levels may be increased w/ food.

Urinary glucose test using cupric sulfate (e.g. Benedict's or Fehling's tests soln, Clinitest^®) may produce false-positive result. May induce a positive direct Coombs' test; false-positive serum or urine creatinine w/ Jaffe' reaction.

Description: Cefpodoxime binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Pharmacokinetics:
Absorption: Rapid and well absorbed from the GI tract (approx 50%). Decreased absorption in low gastric acidity conditions. Food may increase bioavailability. Bioavailability: Approx 50%. Time to peak plasma concentration: Approx 2-3 hr.
Distribution: Reaches bile, resp and genito-urinary tract (therapeutic concentrations); enters breast milk (low concentrations). Plasma protein binding: Approx 20-30%.
Metabolism: De-esterified to cefpodoxime in the intestinal lumen.
Excretion: Via urine (80% as unchanged drug). Plasma half-life: Approx 2-3 hr.

Source: National Center for Biotechnology Information. PubChem Database. Cefpodoxime, CID=6335986, https://pubchem.ncbi.nlm.nih.gov/compound/Cefpodoxima (accessed on Jan. 21, 2020)

Store between 20-25°C. Reconstituted powd: Store between 2-8°C.

Cephalosporins

Anon. Cefpodoxime. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/11/2014.

Buckingham R (ed). Cefpodoxime Proxetil. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/11/2014.

Cefpodoxime Proxetil Granule, for Suspension (Sandoz Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 13/11/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Cefpodoxime Proxetil. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 13/11/2014.