From the Guidelines
Cefpodoxime proxetil is an oral third-generation cephalosporin antibiotic primarily used to treat various bacterial infections, including respiratory tract infections, skin and soft tissue infections, urinary tract infections, and sexually transmitted infections. The typical adult dosage ranges from 100-400 mg taken twice daily for 5-14 days, depending on the infection type and severity, as recommended by the Infectious Diseases Society of America 1. For children, dosing is weight-based, usually 5-10 mg/kg twice daily. Cefpodoxime works by inhibiting bacterial cell wall synthesis, causing bacterial cell death, and is particularly effective against many gram-positive and gram-negative bacteria, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and some Enterobacteriaceae 1.
Some key points to consider when using cefpodoxime proxetil include:
- It should be taken with food to enhance absorption 1
- Patients with penicillin allergies should use caution as cross-reactivity can occur 1
- Cefpodoxime is not effective against MRSA, Pseudomonas, or anaerobic bacteria, so proper culture and sensitivity testing is important before initiating therapy 1
- The clinical utility of the suspension formulation for children is often limited by its poor taste 1
According to the most recent guidelines, cefpodoxime proxetil is a recommended treatment option for community-acquired pneumonia, including cases caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 1. Additionally, it is considered a suitable alternative for patients who are allergic to penicillin or have failed treatment with other antibiotics 1. Overall, cefpodoxime proxetil is a valuable treatment option for various bacterial infections, and its use should be guided by current clinical guidelines and susceptibility testing results.
From the FDA Drug Label
Cefpodoxime proxetil is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below.
Acute otitis media caused by Streptococcus pneumoniae (excluding penicillin-resistant strains), Streptococcus pyogenes, Haemophilus influenzae (including beta-lactamase-producing strains), or Moraxella (Branhamella) catarrhalis (including beta-lactamase-producing strains). Pharyngitis and/or tonsillitis caused by Streptococcus pyogenes Community-acquired pneumonia caused by S. pneumoniae or H.influenzae (including beta-lactamase-producing strains). Acute bacterial exacerbation of chronic bronchitis caused by S.pneumoniae, H.influenzae (non-beta-lactamase-producing strains only), or M.catarrhalis. Acute, uncomplicated urethral and cervical gonorrhea caused by Neisseria gonorrhoeae (including penicillinase-producing strains). Acute, uncomplicated ano-rectal infections in women due to Neisseria gonorrhoeae (including penicillinase-producing strains). Uncomplicated skin and skin structure infections caused by Staphylococcus aureus (including penicillinase-producing strains) or Streptococcus pyogenes. Acute maxillary sinusitis caused by Haemophilus influenzae (including beta-lactamase-producing strains), Streptococcus pneumoniae, and Moraxella catarrhalis Uncomplicated urinary tract infections (cystitis) caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Staphylococcus saprophyticus
The uses of cefpodoxime (Cefpodoxime proxetil) are:
- Respiratory tract infections: acute otitis media, pharyngitis, tonsillitis, community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis
- Genitourinary tract infections: acute, uncomplicated urethral and cervical gonorrhea, acute, uncomplicated ano-rectal infections in women, uncomplicated urinary tract infections (cystitis)
- Skin and skin structure infections: uncomplicated skin and skin structure infections caused by Staphylococcus aureus or Streptococcus pyogenes 2
From the Research
Uses of Cefpodoxime
Cefpodoxime proxetil is an orally administered prodrug that is converted in vivo to the third generation cephalosporin cefpodoxime. The uses of cefpodoxime proxetil include:
- Treatment of community-acquired pneumonia 3, 4, 5, 6
- Treatment of upper respiratory tract infections, such as tonsillitis/pharyngitis or sinusitis 3, 4, 5, 6
- Treatment of lower respiratory tract infections, such as acute bronchitis or acute on chronic bronchitis 3, 4, 5, 6
- Treatment of skin and soft tissue infections 3, 7, 5
- Treatment of urinary tract infections 3, 5
- Empirical treatment of infections in both adult and pediatric patients 3, 7
Specific Indications
Some specific indications for cefpodoxime proxetil include:
- Acute otitis media 7, 5
- Pharyngotonsillitis 3, 7, 5
- Bronchopneumonia 3
- Anogenital gonococcal infections 3
- Abscess, atheroma, furuncle and carbuncle, infected wounds, cellulitis 7
Dosage and Administration
Cefpodoxime proxetil can be administered orally, with a dosage equivalent to 100-400 mg of cefpodoxime, given twice daily 3, 4, 5. In pediatric patients, the dosage is typically 8-10 mg/kg/day, given in 2 divided doses 7. The extended plasma half-life of cefpodoxime permits twice daily administration 3.