Usage
- Azithromycin + Cefpodoxime Proxetil is prescribed for various bacterial infections, including respiratory tract infections (such as sinusitis, bronchitis, and pneumonia), skin and soft tissue infections, urinary tract infections, sexually transmitted infections (like gonorrhea and chlamydia), and acute otitis media (middle ear infection).
- Pharmacological Classification: Antibiotic (Macrolide and Cephalosporin combination).
- Mechanism of Action: This combination exerts a synergistic antibacterial effect. Azithromycin inhibits bacterial protein synthesis, while Cefpodoxime disrupts bacterial cell wall formation.
Alternate Names
- No widely recognized alternate names exist for this specific combination.
- Brand Names: This combination is available under various brand names (e.g., Fypad-AZ). Brand names may vary regionally.
How It Works
- Pharmacodynamics: Azithromycin binds to the 50S ribosomal subunit of bacteria, inhibiting protein synthesis. Cefpodoxime, a third-generation cephalosporin, binds to penicillin-binding proteins (PBPs), inhibiting cell wall synthesis and leading to bacterial cell death. The combination provides broad-spectrum coverage against Gram-positive and Gram-negative bacteria.
- Pharmacokinetics:
- Absorption: Cefpodoxime proxetil is an oral prodrug hydrolyzed to cefpodoxime after absorption. Food can enhance absorption. Azithromycin is also administered orally and well-absorbed.
- Metabolism: Cefpodoxime is minimally metabolized. Azithromycin undergoes some hepatic metabolism.
- Elimination: Cefpodoxime is primarily excreted renally. Azithromycin is eliminated via biliary and renal routes.
- Mode of Action (Cellular/Molecular): Azithromycin interferes with bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing transpeptidation and translocation. Cefpodoxime interferes with bacterial cell wall synthesis by binding to PBPs, ultimately causing cell lysis.
- Elimination Pathways: Cefpodoxime predominantly through renal excretion. Azithromycin through both biliary/fecal and renal routes.
Dosage
Standard Dosage
Adults: The standard dose is typically 200 mg of Cefpodoxime and 250 mg of Azithromycin, administered every 12 hours. Dosages may be adjusted based on the infection’s severity and the patient’s condition.
Children: Dosage in children is weight-based and depends on the age and severity of infection. For children older than 6 months, the dose is usually determined by a doctor based on weight, age, and infection type.
Special Cases:
- Elderly Patients: Dosage adjustment may be needed for elderly patients with renal impairment.
- Patients with Renal Impairment: Reduce dosage based on creatinine clearance.
- Patients with Hepatic Dysfunction: Exercise caution, particularly with Azithromycin, and adjust dosage if necessary.
- Patients with Comorbid Conditions: Consider potential drug interactions with other medications.
Clinical Use Cases
Dosage for specific clinical situations is best determined on a case-by-case basis considering the patient’s specific condition and infection type and should be decided by the supervising physician.
Dosage Adjustments:
- Adjustments may be necessary for renal/hepatic impairment. Consider therapeutic drug monitoring to optimize dosage.
Side Effects
Common Side Effects:
- Nausea, vomiting, diarrhea, abdominal pain, headache, fatigue, dizziness.
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, swelling, difficulty breathing), Clostridium difficile-associated diarrhea, seizures, Stevens-Johnson syndrome.
Long-Term Effects:
- Potential for antibiotic resistance with prolonged use.
Adverse Drug Reactions (ADR):
- Anaphylaxis, severe skin reactions, Clostridium difficile infection.
Contraindications:
- Hypersensitivity to Azithromycin, Cefpodoxime, or other macrolides/cephalosporins.
- History of cholestatic jaundice or hepatic dysfunction associated with prior Azithromycin use.
Drug Interactions:
- Antacids (containing aluminum, magnesium, or calcium), certain cardiac glycosides (digoxin), certain anti-gout medications, anti-epileptic drugs (phenytoin), certain asthma medications, anticoagulants (warfarin), and immune checkpoint inhibitors.
Pregnancy and Breastfeeding:
- Caution is advised. Use only if clearly needed and under medical supervision. Azithromycin passes into breast milk in small amounts.
Drug Profile Summary
- Mechanism of Action: Azithromycin inhibits protein synthesis; Cefpodoxime inhibits cell wall synthesis.
- Side Effects: Nausea, vomiting, diarrhea, headache, allergic reactions.
- Contraindications: Hypersensitivity, history of cholestatic jaundice/hepatic dysfunction with Azithromycin.
- Drug Interactions: Antacids, digoxin, warfarin, and others (see above).
- Pregnancy & Breastfeeding: Use with caution under medical supervision.
- Dosage: Refer to detailed dosage section above.
- Monitoring Parameters: Renal function, liver function tests, signs of superinfection (e.g., C. difficile).
Popular Combinations
No information is available in the sources about popular drug combinations.
Precautions:
- Assess for allergies, renal/hepatic function, and potential drug interactions.
- Patients with a history of penicillin allergy should be monitored closely for hypersensitivity reactions.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Azithromycin + Cefpodoxime Proxetil?
A: Refer to the detailed dosage guidelines above. This will vary depending on age, weight, and the specific infection.
Q2: What are the common side effects?
A: Common side effects include nausea, vomiting, diarrhea, abdominal pain, and headache.
Q3: What are the serious side effects I should be aware of?
A: Serious side effects include severe allergic reactions, Clostridium difficile infection, and seizures.
Q4: Can this drug be used during pregnancy and breastfeeding?
A: Use cautiously under medical supervision. Weigh the risks and benefits. Consult specialist sources for detailed guidelines.
Q5: What are the main contraindications?
A: Hypersensitivity to the components and prior liver problems with Azithromycin are key contraindications.
Q6: Are there any significant drug interactions?
A: Yes, interactions can occur with antacids, digoxin, warfarin, and certain other medications. Refer to Drug interactions section.
Q7: How does this combination work against bacterial infections?
A: Azithromycin inhibits protein synthesis and Cefpodoxime disrupts cell wall formation, working synergistically.
Q8: How long should the treatment course be?
A: The treatment duration depends on the infection. It’s crucial to complete the full course as prescribed.
Q9: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and return to your regular dosing schedule.
Q10: Should this medicine be taken with food?
A: Cefpodoxime is better absorbed with food. Azithromycin can be taken with or without food.
