cefpodoxime proxetil

cefpodoxime proxetil

Orelox (UK), Vantin

Pharmacologic class: Third-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

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.

Availability

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

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• 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.

Adverse reactions

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

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: urticaria, maculopapular or erythematous rash

Other: chills, fever, superinfection, anaphylaxis, serum sickness

Interactions

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

Patient monitoring

• 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.

Patient teaching

• 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.

cefpodoxime proxetil

(sĕf′pə-dŏk′sēm′ prŏk′sə-tĭl)
n.
A broad-spectrum oral cephalosporin antibiotic.

cefpodoxime proxetil (sef´podok´-sēm prok´sətil),

n brand name: Vantin;
drug class: second-generation cephalosporin;
action: inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable;
uses: upper and lower respiratory tract infections, pharyngitis and tonsillitis, gonorrhea, urinary tract infections, skin structure infections.
References in periodicals archive ?
double dagger]) Per 10% increase in cephalosporin prescribing during the previous year; includes cefaclor, cefadroxil, cefdinir, cefditoren pivoxil, cefixime, cefpodoxime proxetil, cefprozil, ceftibuten, cefuroxime axetil, cephalexin, cephradine, and loracarbef.
Tenders are invited for Tab Cefpodoxime Proxetil 100 Mg
The dogs were treated with cleaning of ear canals with solution containing Boric acid 2% and Acetic acid 2% daily for 7 days, Meloxicam for first 3-5 days, Cefpodoxime proxetil orally once daily for two weeks and Ketoconazole for 10 days.
For strep throat, we now have three approved antibiotics for 5 days' treatment: cefdinir, cefpodoxime proxetil, and azithromycin, all evidence based and U.
Only 14 subjects had used the AMAs for the previous episodes which included co-amoxiclav (n=12), cefadroxil (n=1) and cefpodoxime proxetil (n=1), and data was not available in 36 subjects.
06%) Alternatives: amoxicillin-clavulanate 1g bd plus additional 500 mg amoxicillin bd * Antihistamines or 2 g bd SR for 10 days * Mucolytics (guaifenesin) Cefpodoxime proxetil 200 - 400 mg bd for 10 days * Zinc preparations not Cefuroxime axetil 500 mg - 1g bd for 10 days Children Amoxicillin 90 mg/kg/d in 3 divided doses for 10 days Alternatives: amoxicillin-clavulanate 90 mg/kg/d total amoxicillin in 2 or 3 divided doses for 10 days Cefpodoxime proxetil 8 - 16 mg/kg/d bd for 10 days recommended (anosmia) Cefuroxime axetil 15 - 30 mg/kg bd for 10 days (Please see reference 9 for [beta]-l actam allergy and failed initial therapy) 3.
Figure 1 and 2) The patient was treated with cefpodoxime proxetil and methenamine anhydromethylene citrate.
The specialist prescribed empiric cefpodoxime proxetil (Vantin) and ordered stool cultures.
Sodium alginate polymeric floating beads for the delivery of cefpodoxime proxetil (2009) Journal of Applied Polymer Science, 114 (3), pp.
The company is marketing cefpodoxime proxetil oral suspensions in 50-mg/5-mL and 100-mg/5-mL strengths.
The second choice is amoxicillin, the third is cefpodoxime proxetil, and the fourth is cefuroxime axetil.
However, the gastrointestinal absorption of two cephalosporins, cefpodoxime proxetil and cefuroxime axetil, seem to be pH-dependent.