Doxef

Doxef, also known by the generic name cefpodoxime, is an antibiotic from the second-generation cephalosporin group. This drug is used to treat various bacterial infections, such as respiratory tract infections, ear infections, skin infections, urinary tract infections, and others.

Cefpodoxime acts by disrupting bacterial cell wall synthesis, causing bacterial death. It is effective against a broad spectrum of Gram-positive and Gram-negative bacteria. It is not active against methicillin-resistant Staphylococcus aureus (MRSA), but may be effective against some strains resistant to first-generation cephalosporins.

The drug is available in various forms, including tablets and powder for suspension, making it convenient for use by both adults and children. Like any antibiotic, Doxef should be taken strictly as prescribed by a doctor, adhering to the indicated dosage and duration of treatment to minimize the risk of developing antibiotic resistance.

Indications Doxefa

1. Respiratory infections: Doxef may be prescribed to treat bacterial infections of the upper (eg, sinusitis, pharyngitis, laryngitis) and lower (eg, bronchitis, pneumonia) respiratory tract.
2. Urinary tract infections: The drug is effective in cystitis, pyelonephritis and other urinary tract infections caused by microorganisms sensitive to it.
3. Skin infections: Doxef is used for furunculosis, impetigo, cellulitis and other infections of the skin and soft tissues.
4. Bone and joint infections: In some cases, such as osteomyelitis, Doxef may be prescribed as a systemic antibiotic.
5. Septic conditions: In sepsis or other severe systemic infections caused by bacteria sensitive to cefpodoxime, this drug can be used in combination therapy.

Release form

1. Tablets: A commonly used form, Doxef tablets usually contain cefpodoxime in 100 mg, 200 mg, or 400 mg strengths. This form is convenient for adults and children who can swallow tablets.
2. Powder for oral suspension: This formulation is used for children or adults who have difficulty swallowing tablets. The powder is mixed with water according to the instructions, creating a suspension that usually tastes good and is easy to take.

Pharmacodynamics

1. Beta-lactam action: Doxef is a beta-lactam antibiotic, which means that it has a beta-lactam ring in its molecule. This ring plays a key role in the mechanism of action of antibiotics of this class.
2. Transpeptidase Inhibition: Doxef inhibits the activity of the enzyme transpeptidase. This enzyme is essential for the assembly of peptidoglycan, which is the main structural component of the bacterial cell wall.
3. Disruption of cell wall synthesis: When transpeptidase is blocked, the process of peptide synthesis is interrupted. This leads to disruption of the integrity of the bacterial cell wall.
4. Osmotic imbalance and bacterial death: Without cell wall integrity, the bacterial cell becomes vulnerable to the external environment. Osmotic imbalance occurs due to cell wall insufficiency, which ultimately leads to lysis (destruction) of the bacterial cell and its death.

Pharmacokinetics

1. Absorption: Cefpodoxime is generally well absorbed after oral administration. Its absorption is not affected by food intake, which facilitates its use.
2. Distribution: Cefpodoxime is distributed throughout the body, penetrating into various tissues and organs, including the skin, lungs, urinary tract, soft tissues, and bone structures. It can also cross the placental barrier and be excreted in breast milk.
3. Metabolism: Cefpodoxime is almost not metabolized in the body. Most of the drug is excreted unchanged through the kidneys.
4. Elimination: The primary route of elimination of cefpodoxime from the body is via the kidneys via active renal secretion.
5. Elimination half-life: The elimination half-life of cefpodoxime in the body is usually about 1-1.5 hours.
6. Protein binding: Cefpodoxime has low plasma protein binding, which may facilitate its active diffusion into tissues.

Dosing and administration

For adults and children over 12 years old:

• Mild to moderate infections: The usual dose is 200 mg every 12 hours.
• Severe infections: The dose may be increased to 400 mg every 12 hours.

For children aged 6 months to 12 years:

• The dosage is usually calculated based on the child's weight. The recommended dose is 8 to 10 mg per kilogram of body weight every 12 hours. The total daily dose should not exceed 400 mg.

Directions for use:

• Tablets: Taken orally, preferably with food to reduce gastric irritation. Tablets should not be chewed; they should be swallowed whole.
• Suspension: The powder for the preparation of the suspension should be diluted according to the instructions on the package. It is also recommended to take the suspension with food.

Special instructions:

• It is important to take the antibiotic strictly as directed by your doctor and not to stop treatment even if your condition improves, as this can lead to the development of bacterial resistance.
• Regular intake helps maintain a constant concentration of the drug in the blood, which increases its effectiveness.
• During treatment with Doxef, it is necessary to drink plenty of fluids to maintain adequate hydration.

Use Doxefa during pregnancy

Cefpodoxime (Doxef) is generally considered safe for use during pregnancy when prescribed by a doctor. It is classified as an FDA category B drug, indicating that animal studies have not shown a risk to the fetus, although controlled studies have not been conducted in pregnant women.

However, as with any medication, its use during pregnancy should be based on a careful assessment of the potential benefits versus risks. Cefpodoxime is a cephalosporin antibiotic commonly used to treat a wide range of bacterial infections. Given its broad antibacterial activity, it may be a valuable option when an antibiotic is needed during pregnancy.

In clinical practice, it is generally recommended to use such antibiotics when there is no safe alternative and the bacterial infection poses a greater risk to the mother and fetus than the potential risks associated with the drug. Always consult a healthcare professional for personalized advice and treatment during pregnancy.

Contraindications

1. Allergy to cephalosporins. People who are allergic to any other cephalosporin antibiotic should avoid taking cefpodoxime because of the risk of cross-allergic reactions.
2. Severe allergy to penicillins. Patients with severe allergies to penicillin may also have an increased risk of allergic reactions to cephalosporins due to the structural similarities between the two classes of antibiotics.
3. Gastrointestinal disorders, especially antibiotic-associated colitis (pseudomembranous colitis). Cephalosporins may aggravate or contribute to these conditions.

It should also be taken into account that cefpodoxime is used with caution in patients with:

• Chronic kidney disease. In case of renal impairment, dosage adjustment of cefpodoxime may be required, since it is eliminated from the body via the kidneys.
• Pregnancy and breastfeeding. Cefpodoxime should be used during pregnancy only if clearly necessary, as safety data for its use during this period are limited. It may also be excreted in breast milk, which requires caution when breastfeeding.

Side effects Doxefa

1. Gastrointestinal disturbances: These include nausea, vomiting, diarrhea, and abdominal pain. These symptoms may occur because antibiotics can disrupt the balance of normal microflora in the intestines.
2. Allergic reactions: Rash, itching, hives, or more serious reactions such as angioedema and anaphylaxis, although such severe reactions are rare.
3. Pseudomembranous colitis: This is a severe inflammation of the intestines caused by antibiotic-resistant bacteria that can cause severe diarrhea and abdominal pain.
4. Changes in the blood: Such as leukopenia (low white blood cell count), thrombocytopenia (low platelet count), which may result in increased tendency to bleeding or infections.
5. Headache and dizziness: These symptoms may occur intermittently.
6. Increased fatigue or weakness: This can also be a side effect of taking an antibiotic.
7. Candidiasis: The development of fungal infections, such as thrush, may be associated with a disruption of the microflora under the influence of antibiotics.

Overdose

1. Increased side effects: It is possible that the already known side effects of Doxef, such as diarrhea, nausea, stomach pain, allergic reactions and others, may increase.
2. Gut flora imbalance: Overdosing can disrupt normal gut flora, which can lead to diarrhea, colitis, or other digestive problems.
3. Impaired renal function: In case of severe overdose, Doxef may cause toxic effects on the kidneys, which may lead to acute renal failure.
4. Allergic reactions: Serious allergic reactions such as anaphylaxis or anaphylactic shock may occur, especially in people with a predisposition to allergies.
5. Other systemic effects: Overdose may cause various systemic reactions such as electrolyte imbalance, cardiac arrhythmias, and others.

Interactions with other drugs

1. Gastrointestinal drugs: Antiacids containing aluminum, magnesium or calcium, as well as drugs that reduce gastric acidity, may reduce the absorption of cefpodoxime from the gastrointestinal tract. Therefore, their administration should be separated by time or taken at intervals.
2. Drugs that affect kidney function: Drugs that can be toxic to the kidneys or reduce their functional activity can affect the elimination of cefpodoxime from the body. This can lead to its accumulation and an increased risk of side effects.
3. Medicines affecting blood formation: Cefpodoxime may enhance the effect of anticoagulants (eg, warfarin), which may lead to increased bleeding time or increased risk of bleeding.
4. Drugs that affect the intestinal microflora: Taking antibiotics, including cefpodoxime, can disrupt the normal intestinal microflora and contribute to the development of diarrhea or superinfection. The use of probiotics or preparations with live cultures of lactic acid bacteria can help restore the normal microflora.
5. Drugs affecting liver function: Interactions with drugs affecting liver function may affect the metabolism and elimination of cefpodoxime, which may require dosage adjustment.
6. Drugs that cause allergic reactions: Patients who are allergic to penicillins or other cephalosporins may need to exercise caution when taking cefpodoxime due to the possibility of cross-allergy.