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cefpodoxime (Vantin)
Tradename: Vantin. 2nd generation cephalosporin. (cefpodoxime proxetil)
Indications:
- treatment of bacterial infections due to susceptible organisms
a) community acquired pneumonia
b) uncomplicated skin or soft tissue infection
c) acute otitis media
d) pharyngitis
e) uncomplicated urinary tract infection
f) gonorrhea
g) proctitis [3]
Dosage:
1) 100-400 mg PO BID
2) Children: 10 mg/kg/day divided BID
3) take with food
Tab:100, 200 mg
Suspension: 50, 100 mg/5 mL
Dosage adjustment in renal failure:
- reduce dosing to QD with creatinine clearance < 30 mg/mL
Pharmacokinetics:
1) absorption rapid, well absorbed (50%), acid stable, enhanced absorption with food and decreased gastric pH
2) cefpodoxime proxetil is hydrolyzed in GI tract to cefpodoxime
3) distribution: good tissue penetration, including lungs, tonsils & pleural fluid
4) protein binding 18-23%
5) time to peak serum concentration: 1 hour after oral dose
6) elimination 1/2life 2.2 hours, increased with renal insufficiency
7) 80% excreted unchanged into the urine
Antimicrobial activity:
Gram positive
- Streptococcus
- Streptococcus group A
- Streptococcus group B
- Streptococcus group C
- Streptococcus group G
- Streptococcus pneumonia
- Streptococcus viridans, milleri
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis (+/-)
Gram negative
- Neisseria gonorrhoeae
- Moraxella catarrhalis
- Haemophilus influenzae
- Escherichia coli
- Proteus mirabilis
- Proteus vulgaris (+/-)
- Citrobacter species
- Klebsiella [3]
Adverse effects:
1) not common (1-10%)
- diarrhea
2) uncommon (< 1%)
- headache, diaper rash, nausea/vomiting, abdominal pain, pseudomembranous colitis, vaginal fungal infection
3) low incidence of cross-sensitivity to penicillins
Drug interactions:
1) antacids & H2-receptor antagonists reduces absorption of' cefpodoxime
2) probenecid may decrease elimination of cephalosporins
Test interactions:
- positive direct antiglobulin test
Interactions
drug interactions
drug adverse effects of cephalosporins
General
cephalosporin, 2nd generation
Properties
MISC-INFO: elimination route LIVER
KIDNEY
pregnancy-category B
safety in lactation ?
1/2life 2.2 HOURS
protein-binding 18-23%
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Deprecated Reference
- Department of Veterans Affairs, VA National Formulary