Usual Adult Dose for Bronchitis

Acute bacterial exacerbation of chronic bronchitis: 200 mg orally every 12 hours for 10 days

Usual Adult Dose for Cystitis

100 mg orally every 12 hours for 7 days

Usual Adult Dose for Gonococcal Infection - Uncomplicated

Uncomplicated urethral, cervical, or female anorectal infections: 200 mg orally one time

Alternatively, the Centers for Disease Control and Prevention suggest 400 mg orally one time may be effective for both male and female patients as an oral alternative for the treatment of uncomplicated gonorrhea of the cervix, urethra, or rectum.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Cefpodoxime is not indicated for pharyngeal N gonorrhoeae infections.

Usual Adult Dose for Gonococcal Infection - Disseminated

400 mg orally twice a day

Initial therapy for disseminated gonococcal infections requires parenteral therapy which should be continued for 24 to 48 hours after clinical improvement is observed. Oral therapy may then be administered to complete a total course of at least 1 week.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Pneumonia

Community-acquired pneumonia: 200 mg orally every 12 hours for 14 days

Usual Adult Dose for Pyelonephritis

100 mg orally every 12 hours
Therapy should be continued for about 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Sinusitis

200 mg orally every 12 hours for 10 days

Usual Adult Dose for Skin or Soft Tissue Infection

Uncomplicated infection: 400 mg orally every 12 hours for 7 to 14 days

Usual Adult Dose for Tonsillitis/Pharyngitis

100 mg orally every 12 hours for 5 to 10 days
There are insufficient data to establish efficacy in the subsequent prophylaxis of rheumatic fever.

Usual Adult Dose for Upper Respiratory Tract Infection

100 mg orally every 12 hours
Therapy should be continued for approximately 10 to 14 days, depending on the nature and severity of the infection.

Usual Pediatric Dose for Bronchitis

Acute bacterial exacerbation of chronic bronchitis:
12 years or older: 200 mg orally every 12 hours for 10 days

Usual Pediatric Dose for Cystitis

12 years or older: 100 mg orally every 12 hours for 7 days

Usual Pediatric Dose for Gonococcal Infection - Uncomplicated

Uncomplicated urethral, cervical, or female anorectal infections:
12 years or older: 200 mg orally one time

Alternatively, the Centers for Disease Control and Prevention suggest 400 mg orally one time may be effective for both male and female patients as an oral alternative for the treatment of uncomplicated gonorrhea of the cervix, urethra, or rectum.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated.

Cefpodoxime is not indicated for pharyngeal N gonorrhoeae infections.

Usual Pediatric Dose for Gonococcal Infection - Disseminated

12 years or older: 400 mg orally twice a day

Initial therapy for disseminated gonococcal infections requires parenteral therapy which should be continued for 24 to 48 hours after clinical improvement is observed. Oral therapy may then be administered to complete a total course of at least 1 week.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Usual Pediatric Dose for Otitis Media

2 months through 12 years: 5 mg/kg/dose (maximum 200 mg) orally every 12 hours for 5 days
Maximum dose: 400 mg/day

Usual Pediatric Dose for Pneumonia

Community-acquired pneumonia:
12 years or older: 200 mg orally every 12 hours for 14 days

Usual Pediatric Dose for Sinusitis

2 months through 12 years: 5 mg/kg/dose (maximum 200 mg) orally every 12 hours for 10 days
Maximum dose: 400 mg/day

12 years or older: 200 mg orally every 12 hours for 10 days

Usual Pediatric Dose for Skin or Soft Tissue Infection

Uncomplicated infection:
12 years or older: 400 mg orally every 12 hours for 7 to 14 days

Usual Pediatric Dose for Tonsillitis/Pharyngitis

2 months through 12 years: 5 mg/kg/dose (maximum 100 mg) orally every 12 hours for 5 to 10 days
Maximum dose: 200 mg/day

12 years or older: 100 mg orally every 12 hours for 5 to 10 days

There are insufficient data to establish efficacy in the subsequent prophylaxis of rheumatic fever.

Renal Dose Adjustments

CrCl 29 mL/min or less: The dosing interval should be increased to 24 hours.

Liver Dose Adjustments

Data not available

Precautions

Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following cephalosporin therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.

Cephalosporins may be associated with a fall in prothrombin activity. Risk factors include renal or hepatic impairment, poor nutritional state, a protracted course of antimicrobial therapy, and chronic anticoagulation therapy. Prothrombin times should be monitored and vitamin K therapy initiated if indicated.

Serious and occasionally fatal hypersensitivity reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of a skin rash or other signs of hypersensitivity. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.

Dosage adjustments are recommended in patients with renal insufficiency. Some cephalosporins have been associated with seizures in renally impaired patients with elevated serum concentrations. The drug should be discontinued if seizures occur. Nephrotoxicity has occurred with concomitant cephalosporins and aminoglycosides or potent diuretics. Renal function should be monitored, especially in elderly patients.

Dialysis

In patients maintained on hemodialysis, the dose frequency should be 3 times/week after hemodialysis.

Other Comments

Cefpodoxime tablets should be administered orally with food to enhance absorption. Cefpodoxime for oral suspension may be given without regard to food.

The suspension should be stored in a refrigerator and discarded 14 days after reconstitution.