Cefpodoxime proxetil: a new, broad-spectrum, oral cephalosporin.
OBJECTIVE
To discuss the chemistry, pharmacokinetics, spectrum of activity, clinical trials, adverse effects, drug interactions, and dosage guidelines of cefpodoxime proxetil.


METHODS
Literature was identified through a MEDLINE search from 1988 to the present and from review of bibliographies in that literature.


METHODS
Data were limited to comparative trials published in the English literature. Although many studies were conducted in Japan, the results often were available only in Japanese or partly in English. As these studies could not be completely evaluated, they are not included in this review.


RESULTS
Cefpodoxime exhibits good activity against many gram-positive and gram-negative organisms. In clinical trials, cefpodoxime was similar in both clinical and bacteriologic efficacy to amoxicillin, cefaclor, amoxicillin/clavulanate, and penicillin in the treatment of respiratory and urinary tract infections. It also appeared effective in the treatment of skin and soft tissue infections, although no comparative trials have been performed. Cefpodoxime is well tolerated by children and is effective in the treatment of otitis media and pharyngitis. It has a similar adverse effect profile to that of other penicillins and cephalosporins, with gastrointestinal effects being most common.


CONCLUSIONS
Cefpodoxime demonstrates good in vitro activity against pathogens frequently associated with respiratory tract, urinary tract, and skin and tissue infections. It has not demonstrated greater efficacy than the other antibiotics to which it has been compared. The available published clinical trials are fraught with methodologic, statistical, and evaluative flaws. Thus, further trials comparing cefpodoxime with established treatments, as well as the newer cephalosporins, are needed before its place in therapy can be established.
Chocas
E C
EC
College of Pharmacy, University of Texas, Austin 78712.
Paap
C M
CM
Godley
P J
PJ
D000284:Administration, Oral; D000367:Age Factors; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D015296:Ceftizoxime / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D010033:Otitis Media / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012874:Skin Diseases, Infectious / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy; D000097627:Cefpodoxime Proxetil
D015296:Ceftizoxime; D000097627:Cefpodoxime Proxetil