Cefpodoxime dosing

The comorbid conditions that can affect therapy and outcomes in patients with CAP include diabetes mellitus, COPD, congestive heart failure, and renal failure.27,28 If the patient has not received antibiotics in the past 3 months, then clarithromycin or azithromycin is the recommended first-line therapy by the IDSA. If the patient has received antibiotics in the last 3 months, then the IDSA recommends using either a respiratory fluoroquinolone alone or a combination of an oral P-lactam and an advanced macrolide/azalide (e.g., clarithromycin/azithromydn). The ATS recommends combination therapy or monotherapy with a respiratory fluoroquinolone for all patients with comorbidities. The p-lactam agents recommended include high-dose amoxicillin, high-dose amoxicillin-clavulanate, cefpodoxime, cefprozil, and cefuroxime. 

Cefpodoxime proxetil 1 0 mg/kg per day in 2 doses (adult 200 mg twice daily) Diarrhea, diaper rash, vomiting, rash, yeast infections Suspension is bitter tasting... 

If treatment failure occurs with amoxicillin, an agent should be chosen with activity against /1-lactamase-producing H. influenzae and M. catar-rhalis as well as drug-resistant S. pneumoniae (such as high-dose amoxicil-lin-clavulanate (recommended), or, cefuroxime, cefdinir, cefpodoxime, cefprozil, or intramuscular ceftriaxone). 

Cefpodoxime 200 mg twice daily 10 mg/kg/day in two divided doses (maximum 400 mg daily)... 

Cefotaxime can be used in infections due to beta-lactamase producing strains of H. influenzae and N. gonorrhoeae. Ceftriaxone has an antibacterial spectrum similar to that of cefotaxime but its longer half-life allows for less frequent dosing. Ceftazidime is especially effective against Pseudomonas aeruginosa. Cetixime and cefpodoxime are third-generation cephalosporins that can be administered orally. 

The pharmacokinetics of a single 200-mg dose of cefpodoxime proxetil were found to be unchanged by single doses of either diltiazem 60 mg or nifedipine 20 mg in 12 healthy subjects. No special precautions would seem necessary during concurrent use. 

Isotretinoin. A 61-year-old man stabilised on warfarin 2.5 mg daily for 2 to 3 years had a decrease in his INR to below 2.5 after starting oral cefpo-doxime proxetil 200 mg twice daily and oral isotretinoin 30 mg daily for inflammatory lesions of the faee. He required an increase in warfarin dose to 3.75 mg daily. The cefpodoxime was stopped after 10 days without a further change in warfarin requirement. However, when the isotretinoin was discontinued after 40 days, the INR progressively increased and the warfarin dose was eventually redueed to the pretreatment dose of 2.5 mg daily... 

A phase I study that evaluated 17 patients on a combination of irinofecan and cefpodoxime reported that the dose of irinotecan was able to be increased with the use of an oral cephalosporin to ameliorate diarrhoea by way of intestinal decontamination. This practice may increase tolerability of irinotecan, thereby allowing increased exposure to its chemotherapeutic effect [64 ]. 

McGregor L, Stewart C, Crews K, TagenM, Wozniak A, WuJ, etal. Dose escalation of intravenous irinotecan using oral cefpodoxime a phase I study in pediatric patients with refractory solid tumors. Pediatr Blood Cancer 2012 58 372-9. 

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