CEFPODOXIME

Fetal Risk Summary

Cefpodoxime is an oral, semisynthetic cephalosporin antibiotic. Reproduction studies found no evidence in rats of impaired fertility or reproductive performance or, in rats and rabbits, of embryo toxicity or teratogenicity, at doses up to two times the human dose on a mg/m2 basis (1).

No reports describing the use of cefpodoxime during human pregnancy have been located. Cephalosporins are usually considered safe to use during pregnancy (see other cephalosporins for published human experience).

Breast Feeding Summary

According to the manufacturer, low concentrations of cefpodoxime are excreted into human milk (1). Following 200-mg oral doses administered to three women, milk concentrations, as a percentage of concomitant serum levels, 4 hours after the dose were 0%, 2%, and 6%, respectively, and at 6 hours, 0%, 9%, and 16%, respectively. Although not specifically stated for these three women, mean serum concentrations in fasted adults after a 200-mg dose were 2.2 µmg/mL at 2 and 3 hours (peak levels), 1.8 µmg/mL at 4 hours, and 1.2 µmg/mL at 6 hours (1).

In spite of these low levels, three potential problems exist for the nursing infant exposed to cefpodoxime in milk: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. Although not specifically listing cefpodoxime, the American Academy of Pediatrics classifies other cephalosporin antibiotics as compatible with breast feeding (2).

References

1. Product information. Vantin. Pharmacia & Upjohn Company, 1997.
2. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.