Cefpodoxime

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications: 

• Upper and lower respiratory tract infections: Otitis media, tonsilitis, pharyngitis and pneumonia

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Previous history of immediate and/or severe hypersensitivity reactions to penicillins, other cephalosporins or beta-lactam antibacterials

Cautions

• Pregnancy
• Breastfeeding
• Severe renal impairment
• Hypersensitivity to sunset yellow (E110)
• Atypical pneumonia
• Staphylococcal pneumonia
• S. pneumoniae pneumonia
• History of gastrointestinal disease
• Prolonged treatment
• Galactose intolerance
• Lapp lactase deficiency
• Glucose-galactose malabsorption

Forms avail. in SA and covered in this monograph: tab

Infections caused by: Some Gram-positive aerobic organisms (including Streptococcus spp., methicillin-sensitive S. aureus, and C. diptheriae); Some Gram-negative aerobic organisms (including M catarrhalis, N. gonorrhoeae, H. influenzae, P. Mirabilis and Klebsiella spp.)

General dosing range

• Oral (tab): 100-200mg, 12hrly

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Not recommended for use as empiric therapy (administration of antibiotics based on the assumption of a causative organism) in community acquired infections

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Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Tonsillitis
Pharyngitis

• Oral (tab): 100mg, 12hrly; Treatment duration: 5-10 days (Manufacturer recommendation)

Acute sinusitis
Acute exacerbations of chronic bronchitis
Bacterial pneumonia

• Oral (tab): 200mg, 12hrly; Treatment duration: 10 days (Manufacturer recommendation)

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Take tablet with meals

Paed. forms avail. in SA and covered in this monograph: sus, tab

Infections caused by: Some Gram-positive aerobic organisms (including Streptococcus spp., methicillin-sensitive S. aureus, and C. diptheriae); Some Gram-negative aerobic organisms (including M catarrhalis, N. gonorrhoeae, H. influenzae, P. Mirabilis and Klebsiella spp.)

General dosing range

Younger than 1 year

• Not established for use

Between 1-12 years

• Oral (tab, sus): 8mg/kg/day, in 2 divided doses; Max single dose: 200mg

Older than 12 years

• See adult dosage

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Please note that this drug should only be used for definitive therapy (administration of antibiotics based on known results of culture and sensitivities); Not recommended for use as empiric therapy (administration of antibiotics based on the assumption of a causative organism)

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Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Tonsillitis
Pharyngitis
Bacterial pneumonia
Acute otitis media
Acute bacterial sinusitis

Younger than 1 year

• Not established for use

Between 1-12 years

• Oral (tab, sus): 8mg/kg/day, in 2 divided doses; Max single dose: 200mg (Manufacturer recommendation)

Weight (Kg)	Dose (mg) (12hrly)	Dose (ml) (40mg/5ml)
5	20	2.5
10	40	5
15	60	7.5
20	80	10
25	100	12.5

Older than 12 years

• See adult dosage

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Tablet suitable for use in children >25kg

Pregnancy

• Caution
• There are no or limited amount of data from the use of cefpodoxime in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. Due to the benefit of antibiotic treatment, the use of cefpodoxime may be considered during pregnancy if necessary. Caution should be exercised when prescribing to pregnant women

Breastfeeding

• Caution
• Cefpodoxime is excreted in breast milk in small amounts. Cefpodoxime may be used during breastfeeding. Continuation of breastfeeding should be questioned in case of diarrhoea or mucosal fungus infection in the breastfed infant. The possibility of sensitisation should be borne in mind

Renal Impairment

• Mild to moderate: No dose adjustment recommended
• Severe: Caution; dose adjustment recommended

eGFR (ml/min)	Dose
≥30 - 89	No adjustment necessary
≥11- 29	Administer recommended dose every 24hrs
<10	Administer 50% of the recommended dose
Haemodialysis	Administer 50% of the recommended dose; After the dialysis session

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Headache
• Paraesthesia
• Dizziness
• Malaise

Respiratory Disorders

• Bronchospasm

Gastrointestinal Disorders

• Gastric pressure
• Nausea and vomiting
• Abdominal pain
• Flatulence
• Diarrhoea
• Pseudomembranous enterocolitis

Hepatobiliary Disorders

• Increased hepatic enzymes
• Hepatic injury

Genitourinary Disorders

• Increased serum urea
• Increased serum creatinine

Endocrine and Metabolic Disorders

• Loss of appetite

Skin and Subcutaneous Tissue Disorders

• Mucocutaneous reactions
• Rash
• Urticaria
• Pruritis
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis
• Erythema multiforme

Immune, Blood and Lymphatic System Disorders

• Haemolytic anaemia
• Thrombocytosis
• Thrombocytopenia
• Leucopenia
• Eosinophilia
• Hypersensitivity reactions
• Anaphylaxis
• Angioedema
• Purpura
• Multiplication of non-sensitive micro-organisms

Sensory Disorders

• Tinnitus

• Histamine H2-receptor antagonists
• Antacids
• Probenecid
• Oral anticoagulants
• Oral contraceptives
• Nephrotoxic agents

None routine. Specific cases may require

• Full blood count
• Renal function

Cefpodoxime is a broad spectrum, bactericidal cephalosporin. It inhibits bacterial cell wall synthesis following binding to penicillin binding proteins. This results in the interruption of cell wall peptidoglycan biosynthesis, which leads to cell wall lysis secondary to autolytic enzymes which become active when cell wall synthesis is arrested.

Spectrum of activity: Some Gram-positive aerobic organisms (including Streptococcus spp., methicillin-sensitive S. aureus, and C. diptheriae); Some Gram-negative aerobic organisms (including M catarrhalis, N. gonorrhoeae, H. influenzae, P. Mirabilis and Klebsiella spp.)

Tablet 100mg

• Aspen Cefpodoxime (Pharmacare) 
• Cepodem (Ranbaxy)
• Dyna Cefpodoxime (Pharma Dynamics)
• Sandoz Cefpodoxime (Sandoz SA)
• Simayla Cefpodoxime (Ranbaxy)
• Orelox (Sanofi) originator

Tablet 200mg

• Aspen Cefpodoxime (Pharmacare) 
• Cepodem (Ranbaxy)
• Dynacef 200mg (Pharma Dynamics)
• Orelox (Sanofi) originator

Suspension (per 5ml) 40mg 

• Aspen Cefpodoxime (Pharmacare) 
• Cepodem (Ranbaxy)
• Dyna Cefpodoxime (Pharma Dynamics)
• Orchid Cefpodoxime (Watson) (Discontinued: 29/11/2021)
• Orelox Junior (Sanofi) originator
• Oropod (Sandoz)
• Sandoz Cefpodoxime (Sandoz SA)
• Simayla Cefpodoxime (Ranbaxy)