CEFPODOXIMe (cef-po-dox'eem)
Vantin Classifications: antibiotic; third-generation cephalosporin; Therapeutic: antibiotic; cephalosporin Prototype: Cefotaxime sodium Pregnancy Category: B
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Availability
100 mg, 200 mg tablets; 10 mg/mL, 20 mg/mL suspension
Action
Semisynthetic beta-lactam cephalosporin antibiotic. It inhibits the third and final stage of bacterial cell wall synthesis
by preferentially binding to specific penicillin-binding proteins (PBPs) within the bacterial cell wall.
Therapeutic Effect
Has antibacterial activity resembling that of other third-generation cephalosporins. Stable in the presence of beta-lactamases.
Highly active against gram-negative bacteria.
Uses
Gonorrhea, otitis media, lower and upper respiratory tract infections, urinary tract infections.
Unlabeled Uses
Skin and soft tissue infections.
Contraindications
Hypersensitivity to cephalosporins and other beta-lactam antibiotics.
Cautious Use
Renal impairment, history of type I hypersensitivity reactions to penicillins; coagulopathy; history of colitis or other
GI disease; lactation, pregnancy (category B).
Route & Dosage
Respiratory Tract, Skin, and Soft Tissue Infections Adult: PO 200 mg q12h for 10 d Child: PO 10 mg/kg/d divided q12h
Urinary Tract Infections Adult: PO 100 mg q12h
Gonorrhea Adult: PO 200 mg as single dose
Otitis Media Child (5 mo12 y): PO 10 mg/kg/d divided q1224h
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Administration
Oral
- Give with food to enhance absorption.
- Give 1 h before or 2 h after an antacid.
- Consult physician regarding patients with renal impairment (i.e., creatinine clearance less than 30 mL/min); dosage intervals
should be every 12 h.
- Patients on hemodialysis should be given usual dose 3 times weekly after hemodialysis.
- Preparation of suspension: To either the 50 mg/5 mL strength or the 100 mg/5 mL strength, add 25 mL of distilled water,
then shake vigorously for 15 seconds. Next, to the 50 mg/5 mL strength add 33 mL, or to the 100 mg/5 mL strength add 32
mL, of distilled water, and shake for at least 3 minutes.
- Store suspension for up to 14 d in a refrigerator [2°8° C (36°46° F)]. Shake well before using.
Adverse Effects (≥1%)
Body as a Whole: Eye itching, cough, epistaxis, fever, decreased appetite,
malaise.
GI: Diarrhea, nausea, vomiting, abdominal pain, soft stools, flatulance,
pseudomembranous colitis (rare).
CNS: rare: Headache, asthenia, dizziness,
fatigue, anxiety,
insomnia, flushing, nightmares, weakness.
Urogenital: Vaginal
candidiasis.
Skin: Urticaria, rash, scaling, peeling.
Interactions
Drug: antacids,
ranitidine may decrease absorption.
Food: Food may increase the absorption.
Pharmacokinetics
Absorption: 4050% absorbed from GI tract.
Onset: Therapeutic effect in 3 d.
Distribution: Distributes well into inflammatory,
pulmonary, and pleural fluid, and tonsils. Some distribution into prostate. 40%
bound to
plasma proteins. Distributed into breast milk.
Elimination: 80% in urine.
Half-Life: 23 h.
Nursing Implications
Assessment & Drug Effects
- Determine history of hypersensitivity reactions to cephalosporins and penicillins, and history of allergies, particularly
to drugs, before therapy is initiated.
- Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy, if indicated.
Therapy may be instituted pending test results.
- Report onset of loose stools or diarrhea. Although pseudomembranous enterocolitis (see Appendix F) rarely occurs, this potentially
life-threatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy.
- Monitor for manifestations of hypersensitivity (see Appendix F). Discontinue drug and report S&S of hypersensitivity promptly.
- Monitor I&O rates and pattern: Especially important with high doses; report any significant changes.
Patient & Family Education
- Report any signs or symptoms of hypersensitivity immediately.
- Report loose stools, or diarrhea, especially if containing blood, mucus, or pus.
- Complete the full course of drug therapy even if symptoms improve.