Cefpodoxime Dosage and Treatment Regimen
For adults, cefpodoxime is typically administered at 200 mg twice daily for most common infections, with dosage adjustments based on infection severity and site. 1
Adult Dosing
- For uncomplicated urinary tract infections: 100-200 mg twice daily for 7-10 days 1, 2
- For respiratory tract infections: 200 mg twice daily for 5-10 days 1, 3
- For skin and soft tissue infections: 200-400 mg twice daily for 7-10 days 3, 4
- For uncomplicated gonorrhea: 200 mg as a single oral dose, though efficacy is lower than preferred treatments (96.5% cure rate for urogenital/rectal infections) 1
- For more severe infections: Consider 200 mg every 8 hours or 400 mg twice daily 4
Pediatric Dosing
- Standard pediatric dosage: 8-10 mg/kg/day divided into two doses 2, 5
- For acute otitis media: 8-10 mg/kg/day in two divided doses for 5-10 days 5
- For pharyngitis/tonsillitis: 8-10 mg/kg/day in two divided doses for 5-10 days 5
- For lower respiratory tract infections: 8-10 mg/kg/day in two divided doses 5
Treatment Duration
- Respiratory tract infections: 5-10 days (5-day courses have shown similar efficacy to longer regimens in some studies) 1, 4
- Urinary tract infections: 7-10 days 1, 2
- Skin and soft tissue infections: 7-10 days 3, 4
- Uncomplicated gonorrhea: Single 200 mg dose (though not preferred due to lower efficacy) 1
Clinical Considerations
- Cefpodoxime is a third-generation oral cephalosporin prodrug (cefpodoxime proxetil) that is converted to active cefpodoxime in vivo 3
- It has a broad spectrum of activity against both gram-positive and gram-negative bacteria, making it suitable for empiric therapy 3, 2
- The extended plasma half-life (1.9-3.7 hours) allows for convenient twice-daily dosing 3
- For gonorrhea, cefpodoxime is less effective than recommended first-line agents, particularly for pharyngeal infections (78.9% efficacy) 1
- Cefpodoxime has been used successfully as step-down therapy following parenteral antibiotics, potentially reducing hospitalization duration and costs 4
Advantages and Limitations
- Advantages include broad-spectrum activity, twice-daily dosing, and good tolerability profile 3, 5
- Particularly effective against common respiratory pathogens including beta-lactamase producing organisms 2, 6
- Generally well-tolerated with primarily mild to moderate gastrointestinal side effects occurring in 4-15% of patients 3
- Not recommended as first-line therapy for gonorrhea due to lower efficacy compared to ceftriaxone or cefixime 1
- Limited activity against Enterobacter, Citrobacter, Serratia, and Morganella species (MIC ≥4 mg/L) 6