Classification Basis
Cephalosporins are classified into generations based primarily on their spectrum of activity against gram-negative bacteria, with each successive generation typically demonstrating expanded gram-negative coverage 4
Cefpodoxime specifically belongs to the third generation of cephalosporins, distinguishing it from second-generation agents like cefuroxime and cefaclor 4, 1
Key Distinguishing Characteristics of Cefpodoxime as a Third-Generation Agent
Cefpodoxime demonstrates broad-spectrum antibacterial activity encompassing both gram-negative and gram-positive bacteria, which is characteristic of third-generation cephalosporins 3, 5
The drug exhibits stability toward most commonly found plasmid-mediated beta-lactamases, a hallmark feature of third-generation agents 3
Cefpodoxime provides balanced coverage against both gram-positive cocci and gram-negative organisms, distinguishing it from other oral third-generation cephalosporins like cefixime which has limited gram-positive activity 1
The American Academy of Otolaryngology-Head and Neck Surgery recommends cefpodoxime proxetil (200-400 mg twice daily) as the preferred oral third-generation cephalosporin for most community-acquired infections in adults due to its superior gram-positive coverage and excellent gram-negative activity 1
Clinical Formulation
Cefpodoxime is available as an oral prodrug (cefpodoxime proxetil) that is absorbed from the gut and de-esterified by intestinal mucosa to release the active third-generation cephalosporin 2, 3
The extended plasma half-life (1.9 to 3.7 hours) permits twice-daily administration, making it convenient for outpatient therapy 3