Cefpodoxime  (PDF Version)


Antibiotic Class:

Third-Generation Cephalosporin


Antimicrobial Spectrum:

Staphylococcus aureus (methicillin susceptible), Coagulase negative Staphylococci, Streptococcus pneumoniae (penicillin susceptible), Streptococcus spp., Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitides, Neisseria gonorrhoeae, Enterobacteriaceae, E. coli


Mechanism of Action:

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


Adverse Effects:

Hypersensitivity: Maculopapular rash, Urticaria, Pruritis, Anaphylaxis/angioedema, eosinophilia

Hematologic: Hypoprothrombinemia, Neutropenia, Leukopenia, Thrombocytopenia

GI: Diarrhea, C. difficile disease

Renal: Interstitial nephritis

Table 14



PO: 200mg, 400mg tablets

       Oral suspension: 50mg/5mL, 100mg/5mL


Dosing in adults:

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


Dosing in pediatrics:

10g/kg/day divided q12h


Disease state based dosing:

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


Drug Interactions:

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.


Monitoring Requirements:

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.


Brand names/Manufacturer:  Vantin/Pharmacid & Upjohn