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Ceftizoxime, Cefdinir, Cefditoren, Cefpodoxime, Ceftibuten, Cefsulodin, and Cefpiramide
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Mesut Yilmaz, David L. Paterson
Cefpodoxime is also effective for treatment of uncomplicated urinary tract infections (cystitis) caused by E. coli, K. pneumoniae, P. mirabilis, or S. saprophyticus; however, its effectiveness is inferior to other first-line therapies (Grigoryan et al., 2014). Recommendations suggest that cefpodoxime susceptibility among urinary isolates can be inferred from the result of cefazolin (Turnidge et al., 2011).
Cephalosporins
Published in Thomas T. Yoshikawa, Shobita Rajagopalan, Antibiotic Therapy for Geriatric Patients, 2005
The oral cephalosporin cefpodoxime proxetil is an esterified prodrug like cefur-oxime axetil; it is classified as a third-generation cephalosporin because of its broad range of activity that includes S. aureus, S. pneumoniae, M. catarrhalis, Neisseria spp., and many Enterobacteriaceae. It is only 50% absorbed and has a limited spectrum of activity compared with parenteral third-generation cephalosporins, and should not be considered as oral follow-up therapy without serious thought to reliably achievable serum concentrations and sensitivity of the pathogens being treated. Fluoroquinolone antibiotics, for example, have far superior pharmacokinetics and antimicrobial activity, and are significantly less expensive. Cefpodoxime proxetil may be used for follow-up therapy of community-acquired pneumonia in which atypical pathogens are unlikely or for acute exacerbation of chronic obstructive pulmonary disease (COPD).
Assessment of complications after transperineal and transrectal prostate biopsy using a risk-stratified pathway identifying patients at risk for post-biopsy infections
Published in Scandinavian Journal of Urology, 2023
Sebastian Berg, Karl Heinrich Tully, Vincent Hoffmann, Henning Bahlburg, Florian Roghmann, Guido Müller, Joachim Noldus, Moritz Reike
TR biopsy was performed as an outpatient procedure under local anesthesia. As recommended by the currently updated EAU guideline, we have adapted our clinical standards to reduce infectious complications in TR biopsies. Therefore, all patients underwent pre-biopsy rectal swab testing. Based on this rectal swab, patients received targeted prophylaxis. In most cases, cefpodoxime was tested susceptible and could be used as oral prophylaxis (200 mg). Furthermore, we always performed a rectal preparation/cleansing for several minutes before the TR biopsy was started. Biopsies were performed using the Artemis® system (Eigen, Grass Valley, CA, USA) combined with an Ultrasound unit (Noblus) by Hitachi (Hitachi Medical Systems Europe, Steinhausen, Germany) using a transrectal endfire probe (V53V).
Spray dried nanospheres for inclusion complexes of cefpodoxime proxetil with β-cyclodextrin, 2-hydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin: improved dissolution and enhanced antibacterial activity
Published in Drug Development and Industrial Pharmacy, 2021
CEF is a prodrug, third-generation β-lactam cephalosporin, with broad range used in the treatment of upper respiratory tract and urinary system infections (Figure 2). CEF is a BCS type II compound that is absorbed from the gastrointestinal tract following oral administration and de-esterified in vivo to active cefpodoxime. However, CEF is modified to improve the permeability and thus bioavailability of cefpodoxime, it also has just 50% bioavailability when administered orally as a 130 mg tablet (equivalent to 100 mg cefpodoxime) [33,34]. On account of its low aqueous solubility, CEF faces obstacles related to poor dissolution properties and thus results in lower bioavailability, since dissolution is a rate-limiting step in the absorption in intestinal lumen of poorly water-soluble active agents [35,36]. Moreover, the degradation of its ester groups by cholinesterases in the intestine can be another factor in that its low bioavailability. In order to maximize the therapeutic efficiency of CEF, a strategy that will preserve CEF from cholinesterase degradation in intestinal washing and increase CEF solubility is greatly desired [37,38]. For these reasons, CEF belongs to BCS class II is the good choice for approaches to enhance drug solubility, dissolution rate, biological activity and bioavailability. In literature, such strategies were used to improve CEF dissolution rates, antibacterial activity and bioavailability, such as stable lipid nanoparticles [39], submicron sized emulsions [40], self-nanoemulsifying drug delivery systems [37], polymeric micro/nanoparticles [34,38,41], inclusion complexes with β-CD and HP- β-CD [42,43].
Successes, failures, and future prospects of prodrugs and their clinical impact
Published in Expert Opinion on Drug Discovery, 2019
Cefpodoxime proxetil is a third generation orally administered cephalosporin and a prodrug of cefpodoxime. The prodrug is an iso-prooxycarbonyloxy ester which is hydrolysed to cefpodoxime in the intestinal wall and plasma [59]. The asymmetric carbon in the ester chain dictates that the prodrug is supplied as a racemic mixture [60]. As is the case for the third generation cephalosporins, cefpodoxime is active against a wide range of both gram-positive and gram-negative bacteria. It is commonly prescribed for the treatment of upper respiratory tract infections and otitis media.