Cefpodoxime Dosing for a 12-Year-Old Patient
For a 12-year-old patient, administer cefpodoxime 200 mg orally every 12 hours with food, as this patient falls into the adult/adolescent dosing category (≥12 years of age). 1
Standard Dosing Framework
The FDA-approved dosing for adolescents 12 years and older is 200 mg every 12 hours (total daily dose 400 mg) for most respiratory tract infections including pharyngitis, tonsillitis, acute bacterial exacerbations of chronic bronchitis, and acute maxillary sinusitis. 1
For community-acquired pneumonia specifically, the dose remains 200 mg every 12 hours but extends to 14 days duration rather than the typical 5-10 days used for upper respiratory infections. 1
Cefpodoxime must be administered with food to enhance absorption, as bioavailability is 50% and significantly improved when taken with meals. 1, 2
Indication-Specific Dosing
Respiratory Tract Infections:
- Pharyngitis/tonsillitis: 200 mg every 12 hours for 5-10 days 1
- Acute maxillary sinusitis: 200 mg every 12 hours for 10 days 1
- Community-acquired pneumonia: 200 mg every 12 hours for 14 days 1
- Acute bacterial exacerbations of chronic bronchitis: 200 mg every 12 hours for 10 days 1
Other Infections:
- Skin and skin structure infections: 400 mg every 12 hours for 7-14 days 1
- Uncomplicated urinary tract infection: 100 mg every 12 hours for 7 days 1
Clinical Context and Positioning
Cefpodoxime serves as an alternative third-generation cephalosporin when first-line agents like high-dose amoxicillin cannot be used, particularly for β-lactamase-producing Haemophilus influenzae in community-acquired pneumonia. 3, 4
The drug demonstrates excellent activity against common pediatric pathogens including penicillinase-producing staphylococci, streptococci, H. influenzae, E. coli, Klebsiella, and Moraxella. 5
In clinical trials, cefpodoxime 8-10 mg/kg/day (which translates to approximately 200 mg twice daily for a typical 12-year-old) demonstrated equivalent efficacy to amoxicillin/clavulanic acid, cefixime, and cefuroxime axetil for acute otitis media and respiratory infections. 6
Important Administration Considerations
Always administer with food to maximize absorption; antacids or H2-receptor antagonists reduce absorption and should be avoided within 2-3 hours of dosing. 1, 2
Peak plasma concentrations occur 1.9-3.1 hours after administration, with a half-life of 1.9-2.8 hours, supporting twice-daily dosing. 2
For patients with severe renal impairment (creatinine clearance <30 mL/min), extend dosing interval to every 24 hours. 1
No dose adjustment is necessary for patients with hepatic cirrhosis. 1
Common Pitfalls to Avoid
Do not use pediatric weight-based dosing (8-10 mg/kg/day) for a 12-year-old—this patient qualifies for adult/adolescent fixed dosing of 200 mg every 12 hours. 1
Avoid prescribing cefpodoxime without food instructions, as fasted administration significantly reduces bioavailability. 1, 7
Do not prescribe cefpodoxime as first-line therapy for community-acquired pneumonia when high-dose amoxicillin (90 mg/kg/day) is appropriate, as amoxicillin provides superior coverage for penicillin-resistant Streptococcus pneumoniae. 3