頭孢泊肟酯 (Cefpodoxime Proxetil)
Cefpodoxime Proxetil
Cefpodoxime proxetil
別名: Simplicef · Vantin · Banan · Biocef · Cefodox · Cepodem · Garia · Instana · Kelbium · Orelox · Otreon · Podomexef · CS-807 · R-3763 · U-76252 · U-76253
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For susceptible skin infections | 5-10 mg/kg PO once daily | PO | q24h | 5-7 days or 2-3 days beyond cessation of clinical signs, up to a maximum of 28 days. Treatment of acute infections should not be continued for more than 3-4 days if no response to therapy is seen. | 🌎 NA |
- For susceptible skin infections: May be given with or without food.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For susceptible skin and soft tissue infections | 5 mg/kg PO q12h or 10 mg/kg PO once daily | PO | q12h or q24h | — | 🌎 NA |
- For susceptible skin and soft tissue infections: Extrapolated from human dosage.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Foals (neonates) with bacterial infections | 10 mg/kg PO q6-12 hours | PO | q6-12h | — | 🌎 NA |
- Foals (neonates) with bacterial infections: Additional studies required to confirm clinical efficacy and safety.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
頭孢泊肟酯 (Cefpodoxime proxetil) 是一種口服第三代頭孢菌素類抗生素，主要用於獸醫學中治療敏感細菌感染，特別是犬隻的皮膚感染。
- 前驅藥劑型：酯化的「proxetil」成分能提高脂溶性與腸胃道吸收率。吸收後，它會在腸壁迅速水解為具活性的代謝物頭孢泊肟。
- 抗菌譜：對多種革蘭氏陽性菌（如假中間葡萄球菌、金黃色葡萄球菌和犬鏈球菌）及革蘭氏陰性腸桿菌科（如大腸桿菌、奇異變形桿菌、多殺性巴斯德桿菌和克雷伯氏菌）非常有效。
- 臨床要點：它對綠膿桿菌、腸球菌屬、厭氧菌或抗甲氧西林葡萄球菌 (MRSA/MRSP) 無效。在犬隻中每日一次的給藥頻率能顯著提高飼主的順從性，優於如頭孢氨苄等第一代頭孢菌素。
作用機轉
Cefpodoxime is a bactericidal antibiotic that disrupts bacterial cell wall synthesis.
- It binds to specific Penicillin-Binding Proteins (PBPs) located inside the bacterial cell wall.
- Inhibition of PBPs → prevents the cross-linking of peptidoglycan chains → weakens the bacterial cell wall.
- This structural instability → osmotic pressure changes → cell lysis and death.
- As a third-generation cephalosporin, it exhibits increased stability against many bacterial beta-lactamase enzymes compared to earlier generations.
安全性與警告
禁忌症
- Hypersensitivity to cefpodoxime or other cephalosporins
不良反應
- Inappetence
- Diarrhea
- Vomiting
- Hypersensitivity reactions
- Positive direct Coombs' test
- Blood dyscrasias (rare, following high doses)
注意事項
Renal Impairment: Because cefpodoxime is excreted by the kidneys, dosages and/or dosage frequency may need to be adjusted in patients with significantly diminished renal function.
Seizure Disorders: Use with caution in patients with a history of seizure disorders.
Laboratory Interference:
- May cause false-positive urine glucose determinations when using cupric sulfate solution (Benedict's Solution, Clinitest). Glucose oxidase tests are unaffected.
- May cause false-positive results in nitroprusside tests for urinary ketones.
Breeding/Pregnancy: Safety in breeding, pregnant, or lactating dogs has not been demonstrated. Use only when clearly indicated.
藥物交互作用
Potentially additive nephrotoxicity (controversial). In vitro synergy exists, but do not mix together in the same syringe/fluid.
Drugs that increase stomach pH may decrease the absorption of cefpodoxime.
Drugs that increase stomach pH may decrease the absorption of cefpodoxime.
Competitively blocks tubular secretion of cephalosporins, increasing serum levels and half-lives.
Drugs that increase stomach pH may decrease the absorption of cefpodoxime.
監測
- Clinical efficacy (resolution of infection)
- Adverse GI effects
藥物動力學
半衰期
吸收
Cefpodoxime proxetil is a prodrug. After single oral doses (10 mg/kg) to fasted dogs, bioavailability is approximately 63%. In humans, it is 40-50% absorbed; food alters the rate but not the extent of absorption.
分佈
Volume of distribution in dogs is 150 mL/kg. Penetrates most tissues well. In foals, levels in synovial and peritoneal fluids are similar to serum, but no drug was detected in the CSF.
代謝
Hydrolyzed in vivo in the intestinal wall from the inactive proxetil ester to the active antibiotic, cefpodoxime.
排除
Eliminated in both the urine and feces. Serum half-life may be prolonged in patients with impaired renal function.
過量
Cephalosporin overdoses are unlikely to cause significant problems. The most likely signs of acute toxicity or overdose are gastrointestinal disturbances (vomiting, diarrhea, inappetence). Supportive care should be provided if necessary.
可用產品
劑型
- Tablets
- Granules for oral suspension
獸醫用
- Cefpodoxime Proxetil Tablets: 100 mg & 200 mg; Simplicef (Pfizer)
人用標示
- Cefpodoxime Proxetil Oral Tablets: 100 mg & 200 mg; Vantin (Pharmacia & Upjohn), generic
- Cefpodoxime Proxetil Granules for Suspension, Oral: 50 mg/5 mL & 100 mg/5 mL in 50 mL, 75 mL & 100 mL bottles; Vantin (Pharmacia & Upjohn), generic
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Tablets and unreconstituted powder should be stored at 20-25°C in well-closed containers. After reconstitution, the oral suspension should be stored in the refrigerator and discarded after 14 days.
飼主須知
- 給藥方式：可與食物一起或空腹餵食。如果空腹服用後出現嘔吐，請嘗試與少量食物一起餵食。
- 完成療程：
重要提示： 即使寵物看起來已經痊癒，也請務必按照獸醫的指示完成整個療程。提早停藥可能會導致細菌產生抗藥性。
- 副作用：通常耐受性良好。請留意輕微的腸胃不適，如食慾不振、嘔吐或腹瀉。如果症狀嚴重，請聯繫您的獸醫。
- 儲存方式：藥錠請存放於室溫並保持容器密閉。若使用懸浮液，請冷藏保存，並在14天後丟棄未用完的部分。
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