Ceforan (Capsule)

Cefpodoxime is indicated in the following disease:

• Lower respiratory tract infection: Acute community acquired pneumonia, Acute bacterial exacerbation of chronic bronchitis;
• Upper respiratory tract infection: Acute otitis media, Acute maxillary sinusitis, Pharyngitis, Tonsillitis 
• Sexually transmitted diseases: Acute uncomplicated urethral & cervical gonorrhoea.
• Uncomplicated urinary tract infection: Cystitis, Pyuria
• Skin & soft tissue infections: Furuncle, Cellulitis, Subcutaneous abscess, Infectious atheoma, Periproctal abscess.

Cefpodoxime capsules and oral suspension are indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below.

Third generation Cephalosporins

Cefpodoxime binds to 1 or more of the penicillin binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

The recommended doses, duration of treatment, applicable patient population are as below:

Adults (Including age 13 years & older):

• Acute community-acquired pneumonia: 200 mg 12 hourly for 14 days
• Acute bacterial exacerbation of chronic bronchitis: 200 mg 12 hourly for 10 days
• Uncomplicated gonorrhea (men/women): Single dose 200 mg
• Rectal gonococcal infection in women: Single dose 200 mg
• Skin & Soft tissue infection: 200 mg 12 hourly
• Pharyngitis and/or tonsillitis: 100 mg 12 hourly for 5 to 10 days
• Uncomplicated urinary tract infection: 100 mg 12 hourly for 7 days
• Acute maxillary sinusitis: 200 mg 12 hourly for 10 days

Children:

• 15 days to 6 months: 4 mg/kg every 12 hours
• 6 months to 2 years: 40 mg every 12 hours
• 3 to 8 years: 80 mg every 12 hours
• Over 9 years: 100 mg every 12 hours

Cefpodoxime capsule or tablet should be administered orally with food to enhance absorption. Cefpodoxime suspension
may be given without regard to food.

Antacids or H2-blockers may decrease the absorption of cefpodoxime. Reduced renal excretion with probenecid.

Cefpodoxime is contraindicated in patients with known allergy to the cephalosporin class of antibiotics.

Renal Impairment: Patients with renal dysfunction: For patients with severe renal impairment (creatinine clearance <30 ml/min) the dosing intervals should be increased to 24 hourly.

Hepatic Impairment: The dosage does not require modification in cases of hepatic impairment.

Cefpodoxime has very few side-effects. Possible side effects include gastrointestinal disorders (such as diarrhoea, nausea, vomiting and abdominal pain), rash, urticaria and itching.

There are no adequate and well-controlled studies on Cefpodoxime proxetil use in pregnant woman, but it was found neither teratogenic nor embryocidal in animal trial. However, the drug should be used during pregnancy only if clearly needed. In nursing mother, Cefpodoxime is excreted in breast milk & there is potential risk of serious reactions in nursing infants, so a decision should be made whether to discontinue breast feeding or to discontinue the drug.

In patients with transient or persistent reduction in urinary output due to renal insufficiency, the total daily dose of Cefpodoxime should be reduced because high and prolonged serum antibiotic concentration can occur in such individuals following usual doses. Cefpodoxime should be administered with caution to patients receiving concurrent treatment with potent diuretics. As with other antibiotics, prolonged use of  Cefpodoxime may result in overgrowth of nonsusceptible organisms. If superinfection occurs during therapy, appropriate measures should be taken.

Symptoms: Nausea, vomiting, epigastric distress and diarrhoea.
Management: Haemodialysis or peritoneal dialysis may be useful in the event of a serious toxic reaction particularly if renal function is compromised.

Cefpodoxime should not be used in infants less than 15 days old as no experience get exists in this age group.

Cefpodoxime powder for suspension: Shake the bottle well before adding water. Then add 30 ml of boiled and cooled water to make 50 ml suspension. Continue shaking the bottle until the powder is mixed properly.

Cefpodoxime paediatric drops: Shake the bottle well before adding water. Then add 10 ml of boiled and cooled water to make 15 ml suspension. Continue shaking the bottle until the powder is mixed properly.

Capsule: Store below 30° C, protected from light and moisture.

Powder for suspension: Store below 25° C, protected from light and moisture.

After reconstitution: The suspension can be used within 7 days if be kept at room temperature and within 14 days if be kept in refrigerator (2° to 8° C). Always keep the bottle tightly closed.