Generic Name for Vantin
The generic name for Vantin is cefpodoxime proxetil. 1
Drug Classification and Properties
Cefpodoxime proxetil is an orally administered, extended-spectrum, semi-synthetic antibiotic of the cephalosporin class. It is a prodrug that is absorbed from the gastrointestinal tract and de-esterified to its active metabolite, cefpodoxime. 1
Key characteristics:
- It is classified as a third-generation oral cephalosporin 2, 3
- Available in tablet form (100mg and 200mg) 1
- Approximately 50% of the administered dose is absorbed systemically 1
- About 29-33% of the dose is excreted unchanged in urine within 12 hours 1
Antimicrobial Activity
Cefpodoxime has a broad spectrum of activity against common pathogens:
- Gram-positive bacteria: Streptococcus pneumoniae, Staphylococcus aureus (including penicillinase-producing strains) 2
- Gram-negative bacteria: Haemophilus influenzae, Escherichia coli, Klebsiella, Moraxella catarrhalis, Neisseria meningitidis, and Neisseria gonorrhoeae 2
The activity of cefpodoxime proxetil is similar to that of cefuroxime axetil and cefdinir against S. pneumoniae, but greater against H. influenzae. 4
Clinical Uses
Cefpodoxime proxetil is indicated for various infections:
- Upper and lower respiratory tract infections 4, 2
- Acute sinusitis 4
- Otitis media 2, 3
- Pharyngitis/tonsillitis 3
- Skin and soft tissue infections 2, 3
- Urinary tract infections 2
In guidelines for acute sinusitis, cefpodoxime proxetil is recommended as a first-line antibiotic therapy option alongside amoxicillin-clavulanate, cefuroxime-axetil, and other agents. 4
Dosing Considerations
The recommended dose is typically 8-10 mg/kg/day in one or two divided doses for pediatric patients. 2
For adults, the dose ranges from 100-400 mg twice daily depending on the type and severity of infection. 1, 5
Advantages in Clinical Practice
- Twice-daily dosing schedule due to favorable pharmacokinetic profile 3, 6
- Can be used as step-down therapy from parenteral cephalosporins 2, 7
- Effective in short-course therapy (5 days vs. traditional 10-day regimens) for certain infections 2, 7
- Generally well-tolerated with adverse events primarily consisting of gastrointestinal disturbances and skin rashes 3
Common Pitfalls and Considerations
- Food increases the extent of absorption (AUC) by 21-33% for tablet formulation 1
- The suspension formulation for children may have limited clinical utility due to poor taste 4
- Dose adjustment is required in patients with compromised renal function 2
- Not recommended for use against MRSA or Pseudomonas aeruginosa infections 4
Cefpodoxime proxetil represents an important oral option in the cephalosporin class with broad-spectrum activity and convenient dosing, making it valuable for treating various community-acquired infections.