Dosing and uses of Vantin (cefpodoxime)
Adult dosage forms and strengths
oral suspension
- 50mg/5mL
- 100mg/5mL
tablet
- 100mg
- 200mg
Acute Bronchitis & Acute Exacerbations of Chronic Bronchitis
200 mg PO q12hr for 10 days
Acute Community-Acquired Pneumonia
200 mg PO q12hr for 14 days
Acute Maxillary Sinusitis
200 mg PO q12hr for 10 days
Pharyngitis/Tonsillitis
100 mg PO q12hr for 5-10 days
Skin/Skin Structure Infections
400 mg PO q12hr for 7-14 days
Gonorrhea
Uncomplicated gonorrhea in men and women; rectal gonococcal infections in women
200 mg PO once
Uncomplicated Urinary Tract Infections
100 mg PO q12hr for 7-14 days
Dosing Modifications
Renal impairment
- CrCl <30 mL/min: Give q24hr
- Hemodialysis: Give 3 times weekly after dialysis
Hepatic impairment
- Dosage adjustment not necessary
Dosing Considerations
Susceptible organisms
- Bacteroides fragilis, Clostridium perfringens, Escherichia coli, Haemophilus influenzae, Klebsiella spp, Moraxella catarrhalis, Neisseria gonorrhoeae, Proteus mirabilis, staphylococci, group A beta-hemolytic streptococci, Streptococcus pyogenes
Pediatric dosage forms and strengths
oral suspension
- 50mg/5mL
- 100mg/5mL
tablet
- 100mg
- 200mg
Acute Maxillary Sinusitis
<2 months: Safety and efficacy not established
2 months-12 years: 5 mg/kg PO q12hr for 10 days; individual doses not to exceed 200 mg
>12 years: 200 mg PO q12hr for 10 days
Acute Otitis Media
<2 months: Safety and efficacy not established
2 months-12 years: 5 mg/kg PO q12hr for 5 days; individual doses not to exceed 200 mg
>12 years: 200 mg PO q12hr for 5 days
Pharyngitis/Tonsillitis
<2 months: Safety and efficacy not established
2 months-12 years: 5 mg/kg PO q12hr for 5-10 days; individual doses not to exceed 100 mg
>12 years: 100 mg PO q12hr for 5-10 days
Vantin (cefpodoxime) adverse (side) effects
>10%
Diarrhea in infants and toddlers (15.4%)
Diaper rash (12.1%)
1-10%
Diarrhea (7.4%)
Nausea (3.8%)
Vaginal infection (3.1%)
Vomiting (1.1-2.1%)
Abdominal pain (1.6%)
Rash (1.4%)
Headache (1.1%)
Warnings
Contraindications
Documented hypersensitivity
Cautions
Reduce dosage by 50% if CrCl is 10-30 mL/min and by 75% if CrCl is <10 mL/min (high dosages may cause CNS toxicity)
Bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy
Use with caution in patients with history of penicillin allergy
Pregnancy and lactation
Pregnancy category: B
Lactation: Drug excreted in breast milk in low concentrations; not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Vantin (cefpodoxime)
Mechanism of action
Bactericidal against gram-positive and gram-negative bacteria; inhibits bacterial cell-wall synthesis by binding to 1 or more of penicillin-binding proteins; bacteria eventually lyse because activity of cell-wall autolytic enzymes continues while cell-wall assembly is arrested
Absorption
Bioavailability: 50%; acid stable
Peak plasma time: ≤1 hr
Distribution
Distributed well into tissues, including lungs and tonsils; penetrates into pleural fluid
Protein bound: 18-23%
Metabolism
Metabolized in liver to active metabolite
Elimination
Half-life: 2-3 hr; prolonged with renal impairment
Excretion: Urine (80% as unchanged drug) in 24 hr
