Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Orelox (Roussel Uclaf Australia)
100 mg film coated tablets
Indication: respiratory infections
If a cephalosporin is used to treat a resistant infection, it often has to be given by injection.1 Cefpodoxime now offers the possibility of oral therapy for adults with infections resistant to commonly used antibiotics.
This drug is given twice a day with food to increase absorption. The cefpodoxime proxetil ester is rapidly hydrolysed to active cefpodoxime. The active drug is bactericidal and is not hydrolysed by most beta-lactamases.
Cefpodoxime is active against staphylococci, streptococci, Haemophilus influenzae and parainfluenzae, Moraxella catarrhalis and Klebsiella pneumoniae. Pseudomonas aeruginosa is resistant. The drug has been successful in the treatment of bronchitis, community acquired pneumonia, sinusitis and streptococcal pharyngitis/tonsillitis.
Cefpodoxime is mainly excreted in the urine, with a mean elimination half life of 2-4 hours. The dose should be reduced if renal function is impaired.
Adverse reactions were reported in approximately 10% of patients involved in clinical trials. Common adverse effects are diarrhoea and nausea, but anaphylactic shock and pseudomembranous colitis have been reported. As haematological problems, e.g. neutropenia, can occur, the company recommends a blood count if treatment exceeds 10 days.
- Turnidge J. The choice of cephalosporins. Aust Prescr 1992;15:268.