title: Cefpodoxime proxetil in the treatment of lower respiratory tract infections.
abstract: Cefpodoxime proxetil is the orally absorbed ester of cefpodoxime, a new third generation cephalosporin. In the gastrointestinal tract, cefpodoxime proxetil is hydrolysed to cefpodoxime, which has potent antibacterial activity against the major bacterial pathogens involved in lower respiratory tract infections: Haemophilus influenzae, Moraxella (Branhamella) catarrhalis (including beta-lactamase-producing strains), and Streptococcus pneumoniae (including amoxicillin-resistant strains). Six randomised comparative studies in patients with lower respiratory tract infections, 5 of which were large (enrollment of more than 200 patients) and double-blind, examined the efficacy and safety of cefpodoxime proxetil. Cefpodoxime proxetil (at a dosage equivalent to 200mg of cefpodoxime) administered twice daily for 5 to 10 days was similar in clinical and bacteriological efficacy to the following: amoxicillin 500mg 3 times daily in the treatment of community-acquired pneumonia; intramuscular ceftriaxone Ig once daily in the treatment of pulmonary infections in hospitalised patients; and to amoxicillin/clavulanic acid 500/125mg 3 times daily in the treatment of acute exacerbations of chronic bronchitis (AECB). Additionally, a dosage equivalent to 100mg or 200mg of cefpodoxime twice daily was similar in clinical and bacteriological efficacy to amoxicillin 250mg 3 times daily in the treatment of bronchitis (acute or AECB). The adverse events noted with cefpodoxime proxetil administration were similar to those associated with other beta-lactam antibacterials and most commonly involved the gastrointestinal tract and skin or mucous membranes. Thus, cefpodoxime proxetil is a useful addition to the antibacterials available for the treatment of infections of the lower respiratory tract.
authors.affiliation: Department of Communicable and Tropical Diseases, East Birmingham Hospital, England.
authors.forename: A M
authors.initials: AM
authors.lastname: Geddes
mesh_terms: D000368:Aged; D001991:Bronchitis / Q000188:drug therapy / Q000209:etiology*; D015296:Ceftizoxime / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006192:Haemophilus Infections / Q000188:drug therapy* / Q000378:metabolism; D006193:Haemophilus influenzae; D006801:Humans; D001936:Moraxella catarrhalis; D016870:Neisseriaceae Infections / Q000188:drug therapy* / Q000378:metabolism; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000378:metabolism; D011355:Prodrugs / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000378:metabolism; D013296:Streptococcus pneumoniae; D000097627:Cefpodoxime Proxetil
chemical_list: D015296:Ceftizoxime; D011355:Prodrugs; D000097627:Cefpodoxime Proxetil