Cefpodoxime Pediatric Dosing
The recommended dose of cefpodoxime for children is 8-10 mg/kg/day divided into 2 doses every 12 hours, with a maximum not exceeding adult dosing limits. 1
Standard Dosing Regimen
- Administer 8-10 mg/kg/day in 2 divided doses (every 12 hours) for most pediatric infections including community-acquired pneumonia, otitis media, and pharyngitis 1, 2
- The maximum single dose should not exceed adult dosing limits 1
- Treatment duration typically ranges from 5-10 days depending on the infection type 2, 3
Clinical Context and Indications
Cefpodoxime is recommended as alternative oral therapy for:
- Community-acquired pneumonia caused by Streptococcus pneumoniae with penicillin MICs <2.0 μg/mL 1
- Infections caused by Haemophilus influenzae, including β-lactamase producing strains 1
- Upper respiratory tract infections, acute otitis media, and pharyngitis/tonsillitis 2, 3
- Skin and soft tissue infections 2
- Urinary tract infections 3
Age-Specific Cautions
- For infants younger than 5 months, limited data exists on cefpodoxime use, and alternative agents may be preferred 1
- In infants and toddlers (1 month to 2 years), diarrhea occurs in 12.8% and diaper rash in 8.5% of cases 4
Administration Considerations
- Food does not significantly affect the extent of absorption (AUC and Cmax remain similar), though it delays the time to peak concentration by approximately 48% 4, 5
- Cefpodoxime can be administered without regard to meals in children 6 months to 12 years of age 5
- Approximately 50% of the administered dose is absorbed systemically, with 29-33% excreted unchanged in urine within 12 hours 4
Common Pitfalls to Avoid
- Do not use cefpodoxime for infants <5 months without considering alternative agents due to limited safety data 1
- Do not confuse with other cephalosporin dosing: Cefuroxime axetil uses 20-50 mg/kg/day (different from cefpodoxime's 8-10 mg/kg/day) 6
- Monitor for gastrointestinal adverse effects: Diarrhea (6% overall, 12.8% in infants/toddlers) and vomiting (2.3%) are the most common side effects 4
- Ensure appropriate pathogen coverage: Cefpodoxime is only effective against S. pneumoniae with penicillin MICs <2.0 μg/mL 1