Overview

Dry syrups are the mixtures that require the addition of water at the time of dispensing inadequate chemical stability of drug in aqueous vehicle to avoid the physical stability problem.
Cefpodoxime Proxetil Dry Syrup is a cephalosporin antibiotic. It is given as a Cefpodoxime proxetil. Cefpodoxime proxetil is a prodrug which is absorbed and de-esterified by the intestinal mucosa to Cefpodoxime It is active against most Gram positive and Gram negative bacteria. It is commonly used to treat acute otitis media, pharyngitis, and sinusitis.

Indications

It is Used to Treat Number of Bacterial Infections Including:

• Acute otitis media
• Pharyngitis and/or tonsillitis
• Community-acquired pneumonia
• Acute bacterial exacerbation of chronic bronchitis
• Acute, uncomplicated urethral and cervical gonorrhea
• Acute, uncomplicated ano-rectal infections in women
• Uncomplicated skin and skin structure infection
• Acute maxillary sinusitis
• Uncomplicated urinary tract infections (cystitis).

Contraindications

Hypersensitivity reactions to cefpodoxime, other cephalosporins, penicillins, or other drugs.

Contraindicated in Pregnancy and lactation in women, stomach and bleeding disorders.

Side Effects

The Most Commonly Reported Adverse Effects are:

Upset stomach

Diarrhea

Vomiting

Mild skin rash.

Pharmacology

Advantages of using cefpodoxime over other cephalosporins Cefpodoxime is active against a wide spectrum of Gram-positive and Gram-negative bacteria. Cefpodoxime is stable in the presence of beta-lactamase enzymes. As a result, many organisms resistant to penicillins and cephalosporins, due to their production of beta-lactamase, may be susceptible to cefpodoxime.

Mechanism of Action

The bactericidal activity of cefpodoxime results from its inhibition of cell wall synthesis. The active metabolite of cefpodoxime binds preferentially to penicillin binding protein 3, which inhibits production of peptidoglycan, the primary constituent of bacterial cell walls. Cefpodoxime proxetil is a prodrug that is absorbed from the gastrointestinal tract and de-esterified to its active metabolite, cefpodoxime.

Pharmacokinetics

Clavulanic acid binds and inhibits beta-lactamases that inactivate amoxicillin resulting in amoxicillin having an expanded spectrum of activity. Amoxicillin inhibits bacterial cell wall synthesis by binding to one or more of the penicillin- binding proteins which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Interactions

Antacids: Concomitant administration of high doses of antacids (sodium and aluminum hydroxide) or H2 blockers reduces peak plasma levels by 24% to 42% and the extent of absorption by 27% to 32%, respectively. The rate of absorption is not altered by these concomitant medications. Oral anti-cholinergics (e.g., propantheline) delay peak plasma levels (47% increase in Tmax), but do not affect the extent of absorption (AUC).
Probenecid: As with other beta-lactam antibiotics, renal excretion of cefpodoxime was inhibited by probenecid and resulted in an approximately 31% increase in AUC and 20% increase in peak cefpodoxime plasma levels.
Nephrotoxic Drugs: Although nephrotoxicity has not been noted when cefpodoxime proxetil was given alone, close monitoring of renal function is advised when cefpodoxime proxetil is administered concomitantly with compounds of known nephrotoxic potential.
Drug/Laboratory Test Interactions: Cephalosporins, including cefpodoxime proxetil, are known to occasionally induce a positive direct Coombs' test.