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Cefpodoxime Indications & Clinical Uses

Evidence-based guide for pediatric prescribing

Cefpodoxime is a twice-daily oral cephalosporin used as an alternative for common pediatric infections when first-line beta-lactams are unsuitable.

Primary FDA-Approved Indications

Most pediatric use is for AOM and sinusitis as an alternative choice; for GAS pharyngitis it is an option when penicillins cannot be used.

Acute Otitis Media (AOM)

FDA Approved
Children ≥6 monthsLevel B

Alternative when amoxicillin/amoxicillin‑clavulanate cannot be used. Dosed 5 mg/kg/dose BID (10 mg/kg/day) up to 200 mg per dose.

Treatment Duration

Standard: 10 days (Range: 5–10 days)

Evidence Sources

UCSF IDMP: Cefpodoxime ()

Acute Bacterial Rhinosinusitis

FDA Approved
Children and adolescentsLevel B

Consider in select scenarios when amoxicillin‑clavulanate is not appropriate; consult local guidance.

Treatment Duration

Standard: 10 days

Evidence Sources

Medscape: Cefpodoxime ()

GAS Pharyngitis/Tonsillitis

FDA Approved
Children and adolescentsLevel B

Consider only when penicillin or amoxicillin are not options; confirm diagnosis when possible.

Treatment Duration

Standard: 5–10 days

Evidence Sources

UCSF IDMP: Cefpodoxime ()

Secondary Clinical Uses

Uncomplicated SSTI

Secondary Use
Level C

Not a typical first choice; use organism- and guideline-directed therapy.

Evidence Sources

Medscape: Cefpodoxime ()

Clinical Decision Support

Quick Selection Guide

Symptom Cluster 1

Symptoms:

  • Ear pain
  • Fever
  • Irritability

Likely Diagnosis:

AOM

Action:

If penicillins unsuitable, consider cefpodoxime 5 mg/kg/dose BID

Symptom Cluster 2

Symptoms:

  • Purulent nasal discharge
  • Facial pain
  • Persistent symptoms >10 days

Likely Diagnosis:

Acute bacterial sinusitis

Action:

Alternative option when amox‑clav not appropriate

Red Flags & Warnings

Toxic appearance, severe dehydration

Urgent evaluation

Orbital signs in sinusitis (proptosis, ophthalmoplegia)

Urgent imaging and specialty evaluation

Alternative Medication Options

Amoxicillin / Amox‑Clav

Aminopenicillin ± beta‑lactamase inhibitor

First‑line for many URIs unless contraindicated

Advantages
  • Guideline‑preferred for AOM/sinusitis
Disadvantages
  • Not usable in true penicillin allergy

Cefdinir

3rd‑generation cephalosporin

Similar alternative; palatability considerations

Advantages
  • Once‑daily or BID dosing
Disadvantages
  • Iron/antacid interactions; red stool with iron

Parent Communication Guide

When This Medicine Helps

Understanding the Condition

Treats certain ear, sinus, and throat infections caused by bacteria.

Why We Choose This Medicine

Useful when common antibiotics can’t be used.

What to Expect

Symptoms usually improve in 48–72 hours; finish the full course.

Monitoring Your Child

Signs the Medicine is Working:

  • Less ear/sinus pain
  • Lower fever
  • Better sleep and activity

When to Contact Your Doctor:

No improvement after: No better after 72 hours

Watch for these warning signs:

  • Severe headache/eye swelling
  • Neck stiffness
  • Breathing trouble
Last updated: 9/22/2025•Evidence quality: 7/10
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