From the Guidelines
Vantin (cefpodoxime proxetil) should be prescribed at a dose of 200 mg orally every 12 hours for 10 days for the treatment of uncomplicated pyelonephritis. According to the European Association of Urology guidelines on urological infections, published in 2024 1, cefpodoxime is a recommended empirical oral antimicrobial therapy for uncomplicated pyelonephritis. The guidelines suggest a daily dose of 200 mg twice a day for 10 days.
- Key considerations for treatment include:
- Ensuring fluoroquinolone resistance is less than 10% in the region
- Administering an initial intravenous dose of a long-acting parenteral antimicrobial, such as ceftriaxone, if fluoroquinolones are used empirically
- Monitoring for common side effects, such as diarrhea and nausea
- Adjusting the dose for patients with significant renal impairment (creatinine clearance <30 mL/min)
- Encouraging patients to increase fluid intake during treatment and take the medication with food to improve absorption
- Reevaluating patients if symptoms worsen or do not improve within 48-72 hours, as this may indicate antibiotic resistance or complications requiring alternative treatment or hospitalization.
From the Research
Vantin Dose for Pyelonephritis
There is no direct information available about the dose of Vantin (cefepime) for pyelonephritis in the provided studies. However, the following information can be gathered about the treatment of pyelonephritis:
- The studies compared the effectiveness of different antibiotics, including cephalosporins, fluoroquinolones, and trimethoprim-sulfamethoxazole, for the treatment of pyelonephritis 2, 3, 4, 5.
- Cephalosporins, including ceftriaxone, were found to be effective in the treatment of pyelonephritis, with some studies showing superior outcomes compared to fluoroquinolones or trimethoprim-sulfamethoxazole 2, 4, 6.
- The dose of ceftriaxone used in one study was 1g IV every 12 hours for at least 7 days 2.
- Another study found that a 7-day ciprofloxacin regimen was associated with greater bacteriologic and clinical cure rates than a 14-day trimethoprim-sulfamethoxazole regimen for the treatment of acute uncomplicated pyelonephritis in women 5.
- A systematic review found that cephalosporins may be viable treatment options for the management of uncomplicated pyelonephritis, with no trials reporting inferiority of clinical treatment outcomes compared with a fluoroquinolone or trimethoprim-sulfamethoxazole 6.
Key Points
- Cephalosporins, including ceftriaxone, are effective in the treatment of pyelonephritis.
- The dose of ceftriaxone used in one study was 1g IV every 12 hours for at least 7 days.
- Ciprofloxacin and trimethoprim-sulfamethoxazole are also used to treat pyelonephritis, but resistance rates and treatment outcomes may vary.
- Cephalosporins may be viable treatment options for the management of uncomplicated pyelonephritis.