Staphylococcus aureus (methicillin susceptible), Coagulase negative Staphylococci, Streptococcus pneumoniae (penicillin susceptible), Streptococcus spp., Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitides, Neisseria gonorrhoeae, Enterobacteriaceae, E. coli
Cephalosporins exert bactericidal activity by interfering with bacterial cell wall synthesis and inhibiting cross-linking of the peptidoglycan. The cephalosporins are also thought to play a role in the activation of bacterical cell autolysins which may contribute to bacterial cell lysis.
Cephalosporins exhibit time-dependent killing (T > MIC)
Dose of 200mg: Cmax: 2.6 mcg/L; Tmax: 2.4 hour; Half-life: 2.3 hours; Table 10
Hypersensitivity: Maculopapular rash, Urticaria, Pruritis, Anaphylaxis/angioedema, eosinophilia
Hematologic: Hypoprothrombinemia, Neutropenia, Leukopenia, Thrombocytopenia
GI: Diarrhea, C. difficile disease
Renal: Interstitial nephritis
PO: 200mg, 400mg tablets
Oral suspension: 50mg/5mL, 100mg/5mL
Acute exacerbation of chronic bronchitis: 200 mg PO q 12h x 10 days
Lower respiratory tract infection: 200 mg PO q12h x 10 days
Acute maxillary sinusitis: 200 mg PO q12h x 10 days
UTI: 100 mg PO q12h x 7 days
10g/kg/day divided q12h
Renal failure: CrCl < 30 mL/min: increase dosing interval to every 24 hr
Hepatic failure: No dosing changes recommended at this time.
Precautions: hypersensitivity to penicillins, history of gastrointestinal disease, particularly colitis, renal impairment
Antacids: decreased cefpodoxime effectiveness
Calcium: decreased cefpodoxime effectiveness
H2 blockers: decreased cefpodoxime effectiveness
Live Typhoid Vaccine: decreased immunological response to the typhoid vaccine
Probenecid: increased serum cefpodoxime levels
Sodium Bicarbonate: decreased cefpodoxime effectiveness
Category B: No evidence of risk in humans but studies inadequate.
Therapeutic: Culture and sensitivities, serum levels, signs and symptoms of infection, white blood cell count
Toxic: Urinalysis, BUN, SCr, AST and ALT, skin rash, Neutropenia and leukopenia, Prothrombin time in patients with renal or hepatic impairment or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy, and patients previously stabilized on anticoagulant therapy.
Vantin/Pharmacid & Upjohn