What is the weight-based dose of Cepodoxime (Cefpodoxime) for pediatric patients?

Cefpodoxime Weight-Based Dosing in Pediatric Patients

For pediatric patients aged 2 months through 12 years, cefpodoxime is dosed at 10 mg/kg/day (maximum 400 mg/day) divided into two doses given every 12 hours, with 5 mg/kg per dose (maximum 200 mg/dose). 1

Standard Dosing by Indication

Acute Otitis Media

• 10 mg/kg/day divided every 12 hours for 5 days 1
• Maximum daily dose: 400 mg/day 1
• Maximum single dose: 200 mg 1

Pharyngitis and Tonsillitis

• 10 mg/kg/day divided every 12 hours for 5 to 10 days 1
• Maximum daily dose: 200 mg/day 1
• Maximum single dose: 100 mg 1
• Note the lower maximum dose compared to otitis media 1

Acute Maxillary Sinusitis

• 10 mg/kg/day divided every 12 hours for 10 days 1
• Maximum daily dose: 400 mg/day 1
• Maximum single dose: 200 mg 1

Clinical Context and Alternative Therapy

Cefpodoxime serves as an alternative oral agent for community-acquired pneumonia when treating Streptococcus pneumoniae with penicillin MICs <2.0 μg/mL, using the same 8-10 mg/kg/day dosing divided twice daily 2. It is also recommended as an alternative for Haemophilus influenzae infections, particularly when β-lactamase production is present 3, 2.

Administration Considerations

Food Effects

• Cefpodoxime can be administered without regard to meals in children 6 months to 12 years of age 4
• Food delays absorption rate (Tmax increases from 1.93 to 2.79 hours) but does not affect total drug exposure 4
• This allows flexible dosing around meal times without compromising efficacy 4

Age Restrictions

• Limited data exists for infants younger than 5 months, and alternative agents may be preferred in this age group 2
• Approved for use starting at 2 months of age per FDA labeling 1

Important Caveats

Maximum Dose Limits

• Pediatric doses should never exceed adult doses regardless of weight 1
• Adult maximum: 400 mg per dose for most indications 1

Renal Impairment

• For severe renal impairment (creatinine clearance <30 mL/min), extend dosing interval to every 24 hours 1
• For patients on hemodialysis, dose 3 times per week after dialysis 1

Duration Considerations

• 5-day courses have demonstrated equivalent efficacy to 10-day regimens for acute otitis media and pharyngitis 5, 6
• This shorter duration minimizes antibiotic exposure and resistance selection while maintaining clinical effectiveness 5