Drug Interaction Report

Like other beta-lactam antibiotics, the coadministration with probenecid may increase the plasma concentrations of cefditoren pivoxil. The mechanism is competitive inhibition by probenecid of the renal tubular secretion of these antibiotics. According to the manufacturer, a single dose of probenecid increased the mean peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and half-life of a single dose of cefditoren pivoxil by 49%, 122% and 53%, respectively. While this interaction may be exploited to enhance the antibacterial effect of cefditoren pivoxil, the potential for toxicity should be considered if the normal dosage of cefditoren pivoxil is administered with probenecid. A reduced dosage of cefditoren pivoxil may be required.

ADJUST DOSING INTERVAL: Food enhances the oral absorption and bioavailability of cefditoren pivoxil. According to the manufacturer, administration of cefditoren pivoxil following a high-fat meal increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 50% and 70%, respectively, compared to administration in the fasting state. The absolute bioavailability of cefditoren pivoxil is approximately 14% under fasting conditions and 16% when given with a low-fat meal.

MANAGEMENT: To ensure maximal oral absorption, cefditoren pivoxil should be administered with or immediately after a meal.