Cefpodoxime is a beta-lactam antibiotic belonging to the third-generation cephalosporin class. It has a bactericidal action (ie it is able to kill bacterial cells).
Cefpodoxime - Chemical Structure
Indications
For what it uses
Cefpodoxime is used in the treatment of infections caused by bacteria that are sensitive to it.
More specifically, cefpodoxime is indicated for the treatment of:
- tonsillitis;
- sinusitis;
- Medium ear plugs;
- Pneumonia;
- Acute thoracic infections in patients with chronic bronchitis.
Warnings
Caution should be exercised when administering cefpodoxime in patients who have experienced allergic reactions to other types of antibiotics. In these cases, it is necessary to inform the doctor before starting treatment with cefpodoxime.
A reduction in the dose of cefpodoxime usually administered is necessary in patients with renal insufficiency and in peritoneal dialysis.
The administration of cefpodoxime in patients with a history of gastrointestinal disorders - especially in the case of colitis - must be done very carefully.
Cefpodoxime may alter the results of the Coombs test and the results of some tests for the determination of glucose in urine (glycosuria).
Cefpodoxime could cause side effects that alter the ability to drive and use machines, so caution should be used.
Interactions
Cefpodoxime should not be given in combination with drugs used to reduce acid secretion of the stomach, such as:
- Antacids ;
- H2 receptor antagonists for histamine, such as ranitidine, famotidine and cimetidine .
These drugs can only be administered 2-3 hours after taking cefpodoxime.
Also, you need to tell your doctor if you are already taking any of the following medicines:
- Diuretic drugs, such as furosemide ;
- Aminoglycosides, another class of antibiotic drugs;
- Probenecid, a drug used in gout therapy;
- Oral anticoagulants, such as, for example, warfarin .
In any case, you need to inform your doctor if you are taking - or if you have recently been - drugs of any kind, including over-the-counter drugs and herbal and / or homeopathic products.
Side effects
Cefpodoxime can cause various side effects, although not all patients experience them. The type of effects that occur and the intensity with which they occur depends on the sensitivity that each individual has towards the drug.
Listed below are the main adverse effects that may occur during treatment with cefpodoxime.
Allergic reactions
Cefpodoxime can trigger allergic reactions, sometimes severe, in sensitive individuals. These reactions usually show symptoms such as:
- Severe skin rashes;
- Urticaria;
- Itch;
- Swelling of the face and mouth with consequent difficulty in breathing and swallowing;
- Stevens-Johnson syndrome;
- Toxic epidermal necrolysis.
Anaphylactic reactions may also occur, characterized by bronchospasm, purpura and edema of the face and extremities.
Superinfections
Treatment with cefpodoxime can promote the development of superinfections with bacteria resistant to drugs or fungi, such as Clostridium difficile infections or Candida infections in the oral cavity (thrush) or vaginally.
Gastrointestinal disorders
Treatment with cefpodoxime can cause nausea, vomiting, stomach pain, diarrhea, flatulence and stomach bloating.
If the diarrhea appears in severe form, it could be a sign of the occurrence of pseudomembranous colitis caused by a superinfection with Clostridium difficile, therefore, it is necessary to inform the doctor immediately.
Nervous system disorders
Treatment with cefpodoxime can cause headaches, dizziness, tingling, feeling sick and weak.
Blood and lymphatic system disorders
Treatment with cefpodoxime may cause:
- Eosinophilia, ie the increase in plasma concentration of eosinophils;
- Anemia;
- Hemolytic anemia;
- Plateletopenia (ie the decrease in the number of platelets in the bloodstream), with consequent increased risk of bleeding;
- Leukopenia, ie the reduction in the number of leukocytes in the bloodstream.
Other side effects
Other side effects that may occur during cefpodoxime therapy are:
- Perception of ringing in the ears;
- Changes in liver function tests;
- Liver damage;
- Alterations and worsening of renal function;
- Loss of appetite.
Overdose
If you suspect you have taken an overdose of cefpodoxime, you must contact your doctor immediately or contact your nearest hospital.
Action mechanism
Cefpodoxime has its own antibiotic action by interfering with the synthesis of the cell wall of bacteria, the peptidoglycan.
Peptidoglycan is a polymer made up of parallel chains of nitrogenated carbohydrates, joined together by transverse bonds between amino acid residues. These bonds are formed thanks to the action of the transammidase enzyme.
Cefpodoxime binds to transammidase preventing the formation of the aforementioned bonds.
In this way, weak areas are created inside the peptidoglycan that lead to the lysis and death of the bacterial cell.
Mode of Use - Posology
Cefpodoxime is available for oral administration as tablets. For treatment of infections in children, granules for oral suspension are available.
It is important to take the antibiotic always at the same time and after meals, as food promotes the absorption of the drug itself. The duration of treatment is established by the doctor and usually ranges from 5 to 10 days.
It is essential that the antibiotic is taken strictly respecting all the indications provided by the doctor, both as regards the dose of the drug to be taken, and as regards the duration of the therapy.
Following are some indications on the doses of cefpodoxime usually used.
Adults and the elderly
The usual cefpodoxime dose used is 100-200 mg twice a day.
Children up to 11 years
The recommended cefpodoxime dose is 8 mg / kg body weight per day, to be given in two divided doses at 12-hour intervals.
Patients suffering from kidney disease
In this category of patients, the doctor may decide to reduce the doses of cefpodoxime usually administered. The extent of dose reduction depends on the severity of renal disease.
Pregnancy and breastfeeding
The use of cefpodoxime by pregnant women and by breastfeeding mothers should be done only in cases of real need and only after a careful evaluation of the relationship between the expected benefits for the mother and the possible risks for the fetus or the newborn.
In any case, pregnant or breast-feeding women before starting therapy with cefpodoxime - or any other medication - must first seek medical advice.
Contraindications
The use of cefpodoxime is contraindicated in the following cases:
- In patients with known hypersensitivity to cefpodoxime itself, to other cephalosporins or to other beta-lactam antibiotics;
- In patients who have had a severe allergic reaction to penicillins.
