Trizef

Pharmacotherapeutic Group: Antibacterial.
Pharmacology: Antibiotic action: A third-generation cephalosporin, cefpodoxime proxetil is a bactericidal agent that inhibits cell wall synthesis. It's usually active against gram-positive aerobes such as S. aureus (including penicillinase-producing strains). S. saprophyticus, S. pneumonia, and S. pyrogenes, a gram-negative aerobes, such as E. coli, H. influenza (including beta-lactamase-producing strain), K. pneumoniae, M. catarrhalis, Neisseria gonorrhea (including penicillinase-producing strains), and P. mirabilis.
Pharmacokinetics: Cefpodoxime proxetil is de-esterified in the intestinal epithelium following oral administration, to release active cefpodoxime in the blood stream. Bioavailability is about 50% in fasting subjects and may be increased in the presence of food. Absorption is decreased in conditions for low gastric acidity. Plasma concentrations of about 1.5, 2.5 and 4.0 μg per mL have been achieved 2 to 3 hours after oral doses of 100, 200 and 400 mg cefpodoxime respectively. About 20 to 30% of cefpodoxime is bound to plasma proteins. The plasma half-life is about 2 to 3 hours and is prolonged in patients with impaired renal function. Cefpodoxime reaches therapeutic concentrations in the respiratory and genitourinary tracts and bile. It has been detected in low concentrations in breast milk. Cefpodoxime is excreted unchanged in the urine. It is removed by dialysis.

Cefpodoxime proxetil is used for the treatment of susceptible infections including gonorrhea, otitis media, pharyngitis, lower respiratory tract infections such as bronchitis and urinary tract infections.

Adult: Respiratory and Urinary tract infections: Usual dose is 100 mg to 200 mg every 12 hours or as prescribed by the physician.
Skin infections and Soft tissue infections: 200 mg to 400 mg every 12 hours or as prescribed by the physician.
Uncomplicated gonorrhea: Single dose of 200 mg may be given or as prescribed by the physician.
Children: Respiratory tract, Urinary tract, Skin and Soft tissues infections: 200 mg daily or as prescribed by the physician.
Otitis media: 400 mg daily or as prescribed by the physician.
The interval between doses should be extended in patients with severe renal impairment.
Pharyngitis or Tonsilitis: 2 months and older may be given doses of 5 mg/kg every 12 hours, up to a maximum of 200 mg daily or as prescribed by the physician.

Toxic signs and symptoms after an overdose of beta lactam antibiotics may include nausea, vomiting, epigastric distress, and diarrhea.
In the event of serious toxic reaction from overdose, hemodialysis or peritoneal dialysis may help remove drug from the body, particularly if renal function is compromised.

Cefpodoxime proxetil is contraindicated in patients with a known allergy to cefpodoxime or to the cephalosporin group of antibiotics.

In patients with transient or persistent reduction in urinary output due to renal insufficiency, the total daily dose of cefpodoxime proxetil should be reduced because high and prolonged serum antibiotic concentrations can occur in such individuals following usual doses. Cefpodoxime like other cephalosporins, should be administered with caution to patients receiving concurrent treatment with diuretics.

Pregnancy: Teratogenic Effects: Pregnancy Category B.
Cefpodoxime proxetil was neither teratogenic nor embryocidal when administered to rats during organogenesis at doses up to 100 mg/kg/day (2 times the human dose based on mg/m²) or to rabbits at doses up to 30 mg/kg/day (1-2 times the human dose based on mg/m²).
There are however no adequate and well-controlled studies of cefpodoxime proxetil use in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Lactation: Cefpodoxime is excreted in human milk. In study of 3 lactating women, levels of cefpodoxime in human milk were 0%, 2% and 6% of concomitant serum levels at 4 hours following a 200 mg oral dose of cefpodoxime proxetil. At 6 hours post dosing, levels were 0%, 9% and 16% of concomitant serum levels. Because of the potential for serious reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug taking into account the importance of the drug to the mother.

The most frequently reported adverse effects of cefpodoxime are gastrointestinal disturbances, especially diarrhea.

Absorption of cefpodoxime is decreased by concurrent ingestion of antacids or histamine H2-receptor antagonists. Probenecid reduced the renal excretion of cefpodoxime.

Store at temperatures not exceeding 30°C.

Cephalosporins

J01DD13 - cefpodoxime ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.

Rx