Expert opinion on the burden, etiology, and management of respiratory tract infection with a special focus on cefpodoxime in Indian settings

Manjula S.; Krishna Kumar M.

doi:10.18203/2320-6012.ijrms20253598

Authors

Manjula S. Department of Medical Services, Micro Labs Limited, Bangalore, Karnataka, India
Krishna Kumar M. Department of Medical Services, Micro Labs Limited, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253598

Keywords:

Respiratory tract infections, Antibiotic treatment, Cephalosporin, Cefpodoxime, Expert opinion

Abstract

Background: To assess clinician-reported practices in managing respiratory tract infections in Indian settings, with a focus on antibiotic use and experiences with cefpodoxime, including infection prevalence, treatment choices, dosing patterns, and clinical outcomes.

Methods: The cross-sectional study used a 23-item questionnaire to gather the expert opinion among clinicians in managing respiratory tract infections, with a focus on antibiotic use and experiences with cefpodoxime in Indian settings. The study covered various aspects such as infection prevalence, treatment choices, dosing patterns, clinical outcomes, and common infection types. Data visualization, including bar charts, was performed using Microsoft Excel 2013.

Results: The study involved 1,243 clinicians practicing across various settings in India. Cefpodoxime was preferred as the first-line anti-infective for upper respiratory tract infections by approximately 74% of clinicians, with 65% selecting a dose of 10 mg/kg/day. It was prescribed in 11-25% of chronic bronchitis cases by nearly 52% of respondents, in less than 10% of bone and joint infections by 51%, and in 25-50% of ENT infections by 43%. For skin and soft tissue infections, 42% reported using it in less than 10% of cases. Diarrhoea was identified as the most common adverse effect by 50% of clinicians, while approximately 51% considered its broad-spectrum activity to be the main advantage.

Conclusions: This study provides a detailed analysis of the clinical use of cefpodoxime, highlighting its frequent use in upper respiratory and ENT infections, with relatively limited use in chronic bronchitis, bone and joint, and skin and soft tissue infections.

Metrics

Metrics Loading ...

References

Liu Q, Liu M, Liang W, Li X, Jing W, Chen Z, Liu J. Global distribution and health impact of infectious disease outbreaks, 1996-2023: a worldwide retrospective analysis of World Health Organization emergency event reports. J Glob Health. 2025;15:04151. DOI: https://doi.org/10.7189/jogh.15.04151

Jin X, Ren J, Li R, Gao Y, Zhang H, Li J, et al. Global burden of upper respiratory infections in 204 countries and territories, from 1990 to 2019. EClinicalMedicine. 2021;37:100986. DOI: https://doi.org/10.1016/j.eclinm.2021.100986

GBD 2021 Upper Respiratory Infections Otitis Media Collaborators. Global, regional, and national burden of upper respiratory infections and otitis media, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis. 2025;25(1):36–51.

Ta N. ENT in the context of global health. Ann R Coll Surg Engl. 2019;101(2):93–6. DOI: https://doi.org/10.1308/rcsann.2018.0138

Abhilash KPP, Varghese S. Profile and Outcome of Patients Presenting with Skin and Soft-Tissue Infections to the Emergency Department. Current Medical Issues. 2019;17(2):30. DOI: https://doi.org/10.4103/cmi.cmi_22_19

Lwigale F, Kibombo D, Kasango SD, Tabajjwa D, Atuheire C, Kungu J, et al. Prevalence, resistance profiles and factors associated with skin and soft-tissue infections at Jinja regional referral hospital: A retrospective study. PLOS Glob Public Health. 2024;4(8):e0003582. DOI: https://doi.org/10.1371/journal.pgph.0003582

Waghmode R, Jadhav S, Nema V. The Burden of Respiratory Viruses and Their Prevalence in Different Geographical Regions of India: 1970–2020. Front Microbiol. 2021;12:723850. DOI: https://doi.org/10.3389/fmicb.2021.723850

Frampton JE, Brogden RN, Langtry HD, Buckley MM. Cefpodoxime proxetil. A review of its antibacterial activity, pharmacokinetic properties and therapeutic potential. Drugs. 1992;44(5):889–917. DOI: https://doi.org/10.2165/00003495-199244050-00011

Mishra A, Sinal A, Pal A, Gondane A, Pawar D, Sharma A. Clinicians' perspectives on the role of cefpodoxime-clavulanate combination in respiratory tract infection management: a cross-sectional survey. Int J Curr Pharm Rev Res. 2025;17(4):559-66.

Bergogne-Berezin E. Cefpodoxime proxetil in upper respiratory tract infections. Drugs. 1991;42 (Suppl_3):25–33. DOI: https://doi.org/10.2165/00003495-199100423-00007

Hamid OA. and Study of Investigators, co-investigators. Effectiveness and safety of cefpodoxime in upper respiratory tract infections in adult Egyptian population: a report from the Egyptian STAR registry. Egyptian J ENT Allied Science. 2017;18:131-5. DOI: https://doi.org/10.1016/j.ejenta.2017.08.002

Bergogne-Bérézin E. International clinical experience with cefpodoxime proxetil. Current Therapeutic Research. 1996;57(13):103–16. DOI: https://doi.org/10.1016/S0011-393X(96)80107-X

Periti P, Novelli A, Schildwachter G, Schmidt-Gayk H, Ryo Y, Zuck P. Efficacy and tolerance of cefpodoxime proxetil compared with co-amoxiclav in the treatment of exacerbations of chronic bronchitis. J Antimicrob Chemother. 1990;26 (Suppl E):63–9. DOI: https://doi.org/10.1093/jac/26.suppl_E.63

Jain A, Thacker H, Singh J, Manya S, Gautam A, Padalia H. A Study of Expert Perspectives on the Administration of Cefpodoxime and its Combinations in Respiratory Infections: PERCEPT Survey. J Assoc Physicians India 2025;73(7):72-8. DOI: https://doi.org/10.59556/japi.73.1054

Bansal C. Role of cefpodoxime in the treatment of ear infections. International journal of health sciences. 2021;5(S2):1022–31. DOI: https://doi.org/10.53730/ijhs.v5nS2.14086

Shetty K, Hegde RR, Kathuria S, Pareek A. Use of cefpodoxime in ENT infections in Indian patients in the real-world setting. World J Adv Res Rev. 2025;26(3):1546-52. DOI: https://doi.org/10.30574/wjarr.2025.26.3.2133

Tack KJ, Wilks NE, Semerdjian G, Frazier CH, Shirin K, Puopolo A, et al. Cefpodoxime proxetil in the treatment of skin and soft tissue infections. Drugs. 1991;42 (Suppl_3):51–6. DOI: https://doi.org/10.2165/00003495-199100423-00010

Stevens DL, Pien F, Drehobl M. Comparison of oral cefpodoxime proxetil and cefaclor in the treatment of skin and soft tissue infections. Diagn Microbiol Infect Dis. 1993;16(2):123–9. DOI: https://doi.org/10.1016/0732-8893(93)90006-S

Brown RJ, Batts DH, Hughes GS, Greenwald CA. Comparison of oral cefpodoxime proxetil and penicillin V potassium in the treatment of group A streptococcal pharyngitis/tonsillitis. The Cefpodoxime Pharyngitis Study Group. Clin Ther. 1991;13(5):579-88.