Indications

Neoprox (Cefpodoxime Proxetil) is indicated for the treatment of patients infected with susceptible strains of microorganisms, which include a wide range of gram-positive & gram-negative bacteria. As it is highly stable in presence of b-lactamase enzyme, it is more effective against gram-positive bacteria than other 3rd generation oral Cephalosporins.
Neoprox (Cefpodoxime Proxetil) is indicated in the following diseases: -
1. Lower respiratory tract infections: Acute community-acquired pneumonia, acute
   bacterial exacerbation of chronic bronchitis.
2. Upper respiratory tract infections: Acute otitis media, acute maxillary sinusitis,
   pharyngitis, tonsillitis.
3. Sexually transmitted diseases: Acute uncomplicated urethral & cervical
   gonorrhea, acute ano-rectal infection in woman caused by N. gonorrhea.
4. Uncomplicated urinary tract infections: Cystitis, pyuria.
5. Skin & soft tissue infections: Furuncle, cellulitis, subcutaneous abscess,
   Infectious atheroma & periproctal abscess.

Dosage

Children:
15 days - 6 months:  4 mg/kg every 12 hours
6 months - 2 years :  40 mg every 12 hours
3 - 8 years :  80 mg every 12 hours 
Over 9 years :  100 mg every 12 hours

Patients with liver cirrhosis: Cefpodoxime proextil's pharmacokinetics in cirrhotic patients is similar to those in healthy subjects. Dose adjustment is not necessary in this population. 

Interaction

Antacids: Concomitant administrations of high doses of antacids (sodium bicarbonate and aluminum hydroxide) or H2 -blockers reduces plasma level by 24% to 42% and the extent of absorption by 27% to 32% respectively. 
Probenecid: Renal excretion of Cefpodoxime was inhibited by probenecid and resulted in an approximately 31% increase in AUC. 
Nephrotoxic drugs: Close monitoring of renal function advised when Cefpodoxime proxetil is administered concomitantly with compounds of known nephrotoxic potential.

Contraindications

Cefpodoxime proxetil is contraindicated in patients with a known allergy to Cefpodoxime or to the cephalosporin group of antibiotics.

Side Effects

Cefpodoxime has very few side effects. The side effects include diarrhoea, nausea, skin & vaginal fungal infection, abdominal pain, headache, chest pain, myalgia, dyspepsia, dizziness, vertigo, cough etc. In children, incidence of fungal skin rash is more than adults.

Pregnancy & Lactation

Cefpodoxime was neither teratogenic nor embryocidal in animal trial. There is, however, no adequate and well-controlled study of cefpodoxime proxetil in pregnant woman. The drug should be used during pregnancy only if clearly needed.

Precautions & Warnings

In patients with transient or persistent reduction in urinary output due to renal insufficiency, the total daily dose of cefpodoxime proxetil should be reduced. As with other broad-spectrum antibiotics, prolonged use of cefpodoxime proxetil may result in overgrowth of non-susceptible organisms. Repeated evaluation of the patient's condition is essential. 

Overdose Effects

Overdosage may cause toxic reaction. Toxic symptoms include nausea, vomiting, epigastric distress and diarrhea.