What is the recommended dosage of Cefpodoxime (Cefpodoxime proxetil) for children?

Recommended Cefpodoxime Dosage for Children

The recommended dosage of cefpodoxime (cefpodoxime proxetil) for children is 8-10 mg/kg/day administered in two divided doses. 1, 2

Dosing Guidelines

• For most common pediatric infections, cefpodoxime should be administered at 8-10 mg/kg/day divided into two doses 1
• Treatment duration typically ranges from 5 to 10 days, depending on the type and severity of infection 1
• Cefpodoxime can be administered with or without food, though food may delay the rate but not the extent of absorption 3

Indications for Use

Cefpodoxime is indicated for the following pediatric infections:

• Upper respiratory tract infections including:

  • Acute otitis media - 8-10 mg/kg/day in 2 divided doses for 5-10 days 1
  • Pharyngitis/tonsillitis - 8-10 mg/kg/day in 2 divided doses for 5-10 days 1
  • Sinusitis - 10 mg/kg/day in 2 divided doses 2

• Lower respiratory tract infections (primarily pneumonia):

  • As an alternative to other second or third-generation cephalosporins 4
  • Particularly effective for community-acquired pneumonia when treating Streptococcus pneumoniae with MICs for penicillin <2.0 μg/mL 4

• Skin and soft tissue infections:

  • Demonstrated efficacy similar to other oral cephalosporins 1

Clinical Considerations

• For pneumonia treatment: Cefpodoxime is listed as an alternative oral therapy (for step-down therapy or mild infection) for Streptococcus pneumoniae with MICs for penicillin <2.0 μg/mL 4

• Advantages:

  • Twice-daily dosing improves compliance compared to medications requiring more frequent administration 2
  • Broad spectrum of activity against common pediatric pathogens 1
  • Short-course therapy (5 days) has shown similar efficacy to longer courses (10 days) for certain infections like pharyngitis 1, 2

• Pharmacokinetic considerations:

  • Absorption is affected by food (delayed rate but not extent) 3
  • The drug reaches adequate levels exceeding the MIC in most body fluids 2
  • Primarily excreted unchanged by the kidneys 2

Special Populations and Precautions

• Renal impairment: Dose adjustment is necessary in patients with compromised renal function 2

• Age considerations:

  • Cefpodoxime has been studied and is effective in children from 5 months to 12 years of age 3
  • For infants younger than 5 months, limited data is available and alternative agents may be preferred

• Common adverse effects:

  • Primarily gastrointestinal disturbances (diarrhea, vomiting) 1, 5
  • Skin rashes 1
  • Overall well-tolerated with adverse event profile similar to other oral cephalosporins 1

Practical Administration Tips

• Cefpodoxime proxetil is available as an oral suspension for pediatric use 3, 5
• Can be administered without regard to meals, though food may delay absorption 3
• For optimal compliance, emphasize the importance of completing the full course of therapy even if symptoms improve before completion 1