Recommended Pediatric Dose of Cefpodoxime Proxetil
The recommended pediatric dose of cefpodoxime proxetil is 8-10 mg/kg/day administered in 2 divided doses for most common infections. 1, 2, 3
Dosing Guidelines by Age and Indication
- For children aged 5 months and older, cefpodoxime proxetil is administered at 8-10 mg/kg/day divided into two doses for common infections including acute otitis media, pharyngitis, tonsillitis, and lower respiratory tract infections 2, 3
- Limited data is available for infants younger than 5 months, and alternative agents may be preferred according to the Infectious Diseases Society of America 1
- The medication can be administered without regard to meals, although food may delay the rate (but not extent) of absorption 4
Indications for Use
- Cefpodoxime is recommended as an alternative oral therapy for:
- Community-acquired pneumonia when treating Streptococcus pneumoniae with MICs for penicillin <2.0 μg/mL 1
- Infections caused by Haemophilus influenzae 1
- Upper respiratory tract infections including acute otitis media, pharyngitis, and tonsillitis 2, 3
- Lower respiratory tract infections (primarily pneumonia) 2
- Skin and soft tissue infections 2, 3
- Urinary tract infections 3
Treatment Duration
- Treatment duration typically ranges from 5 to 10 days depending on the infection 2, 3
- For pharyngitis/tonsillitis, 5 days of treatment with cefpodoxime proxetil has shown similar clinical efficacy to 10 days of treatment with penicillin V 2
Clinical Considerations
- Cefpodoxime proxetil is available as an oral suspension, making it suitable for pediatric administration 4
- The drug demonstrates good bacteriological and clinical efficacy against common pediatric pathogens 2
- Twice-daily dosing improves medication adherence compared to more frequent dosing regimens 3
Potential Adverse Effects
- Cefpodoxime proxetil is generally well tolerated in pediatric patients 2, 3
- Most common adverse events are gastrointestinal disturbances and skin rashes, consistent with other oral cephalosporins 2
Important Caveats
- Oral cephalosporins (including cefpodoxime) have not received adequate evaluation for gonococcal infections in pediatric patients, and parenteral cephalosporins are recommended instead for these infections 5
- The pharmacokinetic activity of oral cephalosporins in adults cannot be extrapolated to children 5
- Cefpodoxime is administered as a prodrug (cefpodoxime proxetil) which is absorbed from the gut and then converted to the active form 3