Summary
The tissue penetration and clinical efficacy of Cefpodoxime proxetil, a third generation cephalosporin, were studied in odontoiatric patients. Drug concentrations in plasma, saliva, gingiva and alveolar bone were evaluated in 15 patients treated with Cefpodoxime proxetil 400mg (expressed as Cefpodoxime equivalents) administered orally as a single dose, and measured microbiologically using Proteus mirabilis ATCC 21100 as the reference organism. The maximum concentration (Cmax) in plasma was 4.80 mg/L, while Cmax values in gingiva and alveolar bone were 1.51 and 0.82 mg/kg, respectively. These values are above the mean inhibitory concentrations for susceptible pathogens responsible for most odontogenic infections. On the other hand, low levels of Cefpodoxime were detected in saliva (Cmax 0.07 mg/L). Values of the area under the concentration-time curve were calculated from mean concentration-time curves of plasma, gingiva, alveolar bone and saliva, and were 10.13 mg/L/h, 3.26 mg/kg/h, 1.52 mg/kg/h and 0.16 mg/L/h, respectively.
31 patients affected by acute odontogenic infections were treated orally with Cefpodoxime proxetil 100mg (expressed as Cefpodoxime equivalents) twice daily for 5 days. An excellent or good clinical response was obtained in 96.7% of patients overall. Cefpodoxime proxetil was well tolerated in almost all patients; 3 subjects reported adverse reactions consisting of mild nausea, diarrhoea and itching of the hands.
On the basis of drug distribution and clinical data, it may be concluded that Cefpodoxime proxetil achieves bactericidal levels in oral tissues and is an effective treatment for odontogenic infections.
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References
Borin MT. A review of the pharmacokinetics of Cefpodoxime proxetil. Drugs 42 (Suppl. 3): 13–21, 1991
Borin MT, Hughes GS, Spillers CR, Patel RK. Pharmacokinetics of cefpodoxime in plasma and skin blister fluid following oral dosing of Cefpodoxime proxetil. Antimicrobial Agents and Chemotherapy 34: 1094–1099, 1990
Cox CE, Graveline JF, Luongo JM. Review of clinical experience in the United States with Cefpodoxime proxetil in adults with uncomplicated urinary tract infections. Drugs 42 (Suppl. 3): 41–50, 1991
Fujii R. Clinical trials of cefpodoxime proxetil suspension in paediatrics. Drugs 42 (Suppl. 3): 57–60, 1991
Gibaldi M, Perrier D. Pharmacokinetics, 2nd ed., Marcel Dekker, New York, 1982
Jones RN, Barry AL. Antimicrobial activity and disk diffusion susceptibility testing of U-76,253A (R-3746), the active metabolite of the new cephalosporin ester, U-76,252 (CS-807). Antimicrobial Agents and Chemotherapy 32: 443–449, 1988
Komai T, Kawai K, Tsubaki H, Tokui T, Kinoshita T, et al. Absorption, distribution, metabolism, and excretion of CS-807, a new oral cephem antibiotic, in experimental animals. Chemotherapy (Tokyo) 36: 229–340, 1988
Kumazawa J. Summary of clinical experience with cefpodoxime proxetil in adults in Japan. Drugs 42 (Suppl. 3): 1–5, 1991
Safran C. Cefpodoxime proxetil: dosage, efficacy and tolerance in adults suffering from respiratory tract infections. Journal of Antimicrobial Chemotherapy 26 (Suppl. E): 93–101, 1990
Sasaki J. Clinical evaluation of roxithromycin in odontogenic orofacial infections. Journal of Antimicrobial Chemotherapy 20 (Suppl. B): 167–170, 1987
Tack KJ, Wilks NE, Semerdjian G, Frazier CH, Shirin K, et al. Cefpodoxime proxetil in the treatment of skin and soft tissue infections. Drugs 42 (Suppl. 3): 51–56, 1991
Torres J-H, Bons P, Bayssière J, Blayac J-P, Boucard R. Interactions medicamenteuses en odonto-stomatologie. Actualites Odonto-Stomatologiques 171: 407–413, 1990
Tremblay D, Dupront A, Ho C, Coussediere D, Lenfant B. Pharmacokinetics of cefpodoxime in young and elderly volunteers after single doses. Journal of Antimicrobial Chemotherapy 26 (Suppl. E): 21–28, 1990
Utsui Y, Inoue M, Mitsuhashi S. In vitro and in vivo antibacterial properties of CS-807, a new oral cephalosporin. Antimicrobial Agents and Chemotherapy 31: 1085–1092, 1987
Werner H, Heizmann WR, Hoflsauer M. Comparative in vitro activity of cefpodoxime against anaerobes other than Bactcroides fragilis. Infection 19: 370–377, 1991
Wiedemann B, Luhmer E, Zuhlsdorf MT. Microbiological evaluation of Cefpodoxime proxetil. Drugs 42 (Suppl. 3): 6–12, 1991
Wise R. The pharmacokinetics of the oral cephalosporins — a review. Journal of Antimicrobial Chemotherapy 26 (Suppl. E): 13–20, 1990
Wise R, Andrews JM, Ashby JP, Thornber D. The in-vitro activity of cefpodoxime: a comparison with other oral cephalosporins. Journal of Antimicrobial Chemotherapy 25: 541–550, 1990
Yamamoto T, Yasuda SJ, Kanao M, Okada H. CS-807 in the field of obstetrics and gynecology. Chemotherapy (Tokyo) 36 (Suppl. 1): 967–978, 1988
Yokota T, Suzuki E, Arai K. Cefpodoxime proxetil, its in vitro antibacterial activity, affinity to bacterial penicillin-binding proteins, and synergy of bactericidal activity with serum complement and mouse-cultured macrophages. Drugs Under Experimental and Clinical Research 14: 495–500, 1988
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Del Tacca, M., Danesi, R., Blandizzi, C. et al. Periodontal Tissue Distribution of Cefpodoxime Proxetil and Efficacy in Acute Odontogenic Infections. Drug Invest 5, 313–319 (1993). https://doi.org/10.1007/BF03259238
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DOI: https://doi.org/10.1007/BF03259238