Pharmacologic class: Third-generation cephalosporin
Therapeutic class: Anti-infective
Pregnancy risk category B
Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity.
Oral suspension: 50 mg/5 ml, 100 mg/5 ml
Tablets: 100 mg, 200 mg
Indications and dosages
➣ Acute community-acquired pneumonia caused by Haemophilus influenzae or Streptococcus pneumoniae
Adults and children ages 13 and older: 200 mg P.O. q 12 hours for 14 days
➣ Acute bacterial or chronic bronchitis
Adults and children ages 13 and older: 200 mg P.O. q 12 hours for 10 days
➣ Uncomplicated gonorrhea; rectal gonococcal infection caused by Neisseria gonorrhoeae
Adults: 200 mg P.O. as a single dose
➣ Uncomplicated urinary tract infections caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus saprophyticus
Adults: 100 mg P.O. q 12 hours for 7 days
➣ Skin and soft-tissue infections caused by Staphylococcus aureus and Streptococcus pyogenes
Adults and children ages 13 and older: 400 mg P.O. q 12 hours for 7 to 14 days
➣ Acute otitis media caused by H. influenzae, S. pneumoniae, and Moraxella catarrhalis
Children ages 5 months to 12 years: 5 mg/kg P.O. q 12 hours (maximum of 200 mg/dose) or 10 mg/kg q 24 hours (maximum of 400 mg/dose) for 10 days
➣ Tonsillitis and pharyngitis caused by S. pyogenes
Adults and children ages 13 and older: 100 mg P.O. q 12 hours for 5 to 10 days
Children ages 2 months to 12 years: 5 mg/kg P.O. q 12 hours for 5 to 10 days
• Renal impairment
• Hypersensitivity to cephalosporins or penicillins
Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease
• elderly patients
• pregnant or breastfeeding patients
• Obtain specimens for culture and sensitivity testing as necessary before starting therapy.
• Give tablets with food to enhance absorption. Oral suspension may be given with or without food.
• Don't give antacids within 2 hours of cefpodoxime.
CNS: headache, lethargy, paresthesia, syncope, seizures
CV: hypotension, palpitations, chest pain, vasodilation
EENT: hearing loss
GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis
GU: vaginal candidiasis, nephrotoxicity
Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression
Hepatic: hepatic failure, hepatomegaly
Skin: urticaria, maculopapular or erythematous rash
Other: chills, fever, superinfection, anaphylaxis, serum sickness
Drug-drug. Aminoglycosides, loop diuretics: increased risk of nephrotoxicity
Antacids: decreased cefpodoxime absorption
Probenecid: decreased excretion and increased blood level of cefpodoxime
Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels
Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results
Hemoglobin, platelets, white blood cells: decreased values
Drug-herbs. Angelica, anise, arnica, asafetida, bogbean, boldo, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, horse chestnut, horseradish, licorice, meadowsweet, onion, papain, passionflower, poplar, prickly ash, quassia, red clover, turmeric, wild carrot, wild lettuce, willow: increased risk of bleeding
• Assess CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.
• Be aware that cross-sensitivity to penicillins may occur.
• Instruct patient to take drug with food or milk to reduce GI distress and enhance absorption.
• Advise patient not to take antacids within 2 hours of drug.
• Tell patient to continue to take full amount prescribed even when he feels better.
• Instruct patient to report signs and symptoms of allergic response and other adverse reactions, such as rash, easy bruising, bleeding, severe GI problems, or difficulty breathing.
• If patient is being treated for gonorrhea, instruct him to have partner tested and treated (as needed) and to use barrier contraception to prevent reinfection.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.
ClassificationTherapeutic: anti infectives
Pharmacologic: third generation cephalosporins
- Skin and skin structure infections,
- Uncomplicated urinary tract infections,
- Uncomplicated gynecological infections including gonorrhea,
- Respiratory tract infections,
- Otitis media.
- Haemophilus influenzae (including β-lactamase-producing strains),
- Escherichia coli,
- Klebsiella pneumoniae,
- Neisseria gonorrhoeae,
Time/action profile (blood levels)
|PO||unknown||2–3 hr||12 hr|
Adverse Reactions/Side Effects
Central nervous system
- seizures (very high doses) (life-threatening)
- pseudomembranous colitis (life-threatening)
- diarrhea (most frequent)
- abdominal pain
- vaginal moniliasis
- blood dyscrasias
- hemolytic anemia
- allergic reactions including anaphylaxis (life-threatening)
Drug-Drug interactionProbenecid ↓ excretion and increases blood levels.Concurrent use of loop diuretics or nephrotoxic agents including aminoglycosides may ↑ risk of nephrotoxicity.Antacids or histamine H2 receptor antagonists ↓ absorption of cefpodoxime (take 2 hr before or after).
Renal ImpairmentOral (Adults) CCr <30 mL/min—Increase dosing interval to every 24 hr.
Availability (generic available)
- Assess patient for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy.
- Before initiating therapy, obtain a history to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response.
- Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.
- Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify the physician or other health care professional immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.
- Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
- Lab Test Considerations: May cause positive results for Coombs' test.
- May cause ↑ serum AST, ALT, alkaline phosphatase, bilirubin, LDH, BUN, and creatinine.
- May rarely cause leukopenia, neutropenia, agranulocytosis, thrombocytopenia, eosinophilia, lymphocytosis, and thrombocytosis.
Potential Nursing DiagnosesRisk for infection (Indications, Side Effects)
Diarrhea (Adverse Reactions)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)
- Oral: Administer around the clock. Administer tablets with meals to enhance absorption. Suspension may be administered without regard to meals. Shake oral suspension well before administering. Suspension is stable for 14 days after reconstitution in refrigerator.
- Do not administer concurrently with antacids or other drugs taken to reduce stomach acid.
- Instruct patient to take medication at evenly spaced times and to finish the medication completely, even if feeling better. Take missed doses as soon as possible unless almost time for next dose; do not double doses. Instruct patient to use calibrated measuring device with suspension. Advise patient that sharing of this medication may be dangerous.
- Advise patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy.
- Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.
- Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.