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Cefpodoxime proxetil is an oral third‑generation cephalosporin used in pediatrics as an alternative for acute otitis media and sinusitis, especially in non‑anaphylactic penicillin allergy, dosed by weight as a 50 or 100 mg/5 mL suspension.
Typical pediatric regimen: 10 mg/kg/day divided q12h (5 mg/kg/dose BID), commonly 5–10 day courses depending on condition.
Max daily dose often 400 mg/day (200 mg per dose BID).
Absorption improves when taken with food; avoid giving with antacids or H2 blockers close to the dose due to reduced absorption.
Alternative for AOM and sinusitis; not first-line when amoxicillin/amoxicillin-clavulanate is suitable.
Cephalosporin allergy is a contraindication; cross-reactivity with penicillins is low but caution is advised.
Cefpodoxime is a twice-daily oral cephalosporin used as an alternative for common pediatric infections when first-line beta-lactams are unsuitable.
Most pediatric use is for AOM and sinusitis as an alternative choice; for GAS pharyngitis it is an option when penicillins cannot be used.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| Acute Otitis Media (AOM) | Children ≥6 months | No | Alternative when penicillin allergy (non-anaphylactic) or when first-line therapy is not suitable. |
| Acute Bacterial Rhinosinusitis | Children and adolescents | No | Consider in select cases when amoxicillin-clavulanate is not an option; follow local guidance. |
| Streptococcal Pharyngitis/Tonsillitis | Children and adolescents | No | Alternative therapy for S. pyogenes; penicillin/amoxicillin remain preferred when tolerated. |
| Uncomplicated skin and soft tissue infections (SSTI) | Children and adolescents | No | Use guided by local resistance and organism; other agents often preferred for SSTI. |
FDA-approved primary uses with Level A evidence
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Cefpodoxime is generally well tolerated in children. Most side effects are mild and self‑limited.
Common effects include gastrointestinal upset and loose stools. Allergic reactions are uncommon but require urgent attention if they involve hives, swelling, or breathing difficulty.
Nausea/abdominal discomfort
Common • Mild
Diarrhea
Common • Mild–moderate
Maculopapular rash (delayed)
Uncommon • Mild–moderate
Urticaria/angioedema (IgE)
Rare • Severe
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Food improves absorption; routines improve adherence.
Give cefpodoxime with food to improve absorption and reduce stomach upset. Shake the suspension well, and measure doses with an oral syringe or dosing spoon, not a household spoon. Space doses about 12 hours apart when prescribed twice daily, and complete the full course even if your child feels better sooner.
If a dose is missed, give it as soon as remembered unless it’s close to the next dose—do not double doses. Use reminders or a chart to track morning/evening doses.
Emergency contact: Call your clinician urgently for hives, swelling of the face or throat, trouble breathing, severe persistent vomiting, blood in stool, or if your child appears very unwell.
Most children tolerate cefpodoxime well. Accurate measuring, giving with food, and finishing all doses are the biggest factors for success.
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Third‑generation oral cephalosporin with PBP‑mediated, time‑dependent bactericidal activity.
Active against common respiratory pathogens (e.g., H. influenzae, M. catarrhalis, some S. pneumoniae).
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Evidence‑informed pearls to improve outcomes with cefpodoxime.
Administer with meals; avoid antacids/H2 blockers near dosing to maintain exposure.
Consider when amoxicillin or amox‑clav are not options; confirm indication and duration.
Common caps: 200 mg per dose (BID) up to 400 mg/day; verify per local guidance.
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Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Cefpodoxime and monitor your child's response to treatment.
Yes. Food improves absorption and can reduce stomach upset.
Give it when remembered unless it’s close to the next dose. Do not double doses.
Most children improve within 48–72 hours. Continue to the end of the prescribed course.
Possibly. Cephalosporin cross‑reactivity is low in non‑anaphylactic penicillin allergy, but review your child’s allergy history with a clinician first.