What is the typical dosage and treatment duration for Cepodoxime (Cefpodoxime) in adults?

Cefpodoxime (Cefpodoxime Proxetil) Dosage and Treatment Duration in Adults

The typical dosage of cefpodoxime for adults is 200 mg twice daily, with treatment duration ranging from 5-14 days depending on the type of infection being treated. 1

Standard Adult Dosing Regimens

• Respiratory Tract Infections:

  • Acute maxillary sinusitis: 200 mg twice daily for 10 days 1, 2
  • Community-acquired pneumonia: 200 mg twice daily for 7-14 days 1, 3

• Skin and Skin Structure Infections:

  • 400 mg twice daily for 7-14 days 1

• Urinary Tract Infections:

  • Uncomplicated UTI: 100 mg twice daily for 7 days 1
  • Sexually transmitted infections (uncomplicated gonorrhea): 200 mg single dose 1

Dosage Adjustments

• Renal Impairment:

  • For patients with severe renal impairment (creatinine clearance <30 mL/min): Increase dosing interval to once daily (every 24 hours) 1
  • For hemodialysis patients: Administer dose 3 times per week after hemodialysis 1

• Hepatic Impairment:

  • No dosage adjustment required for patients with cirrhosis (with or without ascites) 1

Pharmacokinetic Considerations

• Cefpodoxime proxetil is a prodrug that is converted in vivo to the active cephalosporin cefpodoxime 4
• Can be administered without regard to food 1
• The drug is primarily excreted unchanged by the kidneys 4
• Has a broad spectrum of activity against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 4, 3

Clinical Applications

• Cefpodoxime is a third-generation cephalosporin recommended as one of the first-line antibiotics for:

  • Acute maxillary sinusitis 2
  • Lower respiratory tract infections 3
  • Step-down therapy from parenteral antibiotics 5

• In sinusitis treatment, cefpodoxime has been shown to be effective in 5-day regimens, which is shorter than traditional 10-day courses of some other antibiotics 5

Comparative Efficacy

• Studies have shown cefpodoxime to be as effective as amoxicillin-clavulanate in the treatment of respiratory infections 2
• In a study comparing cefpodoxime with trimethoprim-sulfamethoxazole for uncomplicated cystitis, cefpodoxime demonstrated excellent clinical and microbiological cure rates 2

Common Side Effects

• Primarily gastrointestinal disturbances (diarrhea most common) 6
• Skin rashes 6
• Side effect profile is consistent with other oral cephalosporins 6

Important Considerations

• For respiratory infections, cefpodoxime is particularly useful when there are concerns about resistant pathogens 2
• The twice-daily dosing schedule may improve patient compliance compared to medications requiring more frequent administration 4
• In areas with high prevalence of penicillin-resistant Streptococcus pneumoniae, cefpodoxime may be preferred over amoxicillin for respiratory infections 2

Remember that antimicrobial resistance patterns vary by region, so local susceptibility patterns should be considered when selecting an antibiotic regimen 2.