Cefixime: Potent Oral Cephalosporin for Effective Bacterial Infection Control
Cefixime is a third-generation cephalosporin antibiotic renowned for its broad-spectrum activity against a wide range of Gram-positive and Gram-negative bacteria. It functions by inhibiting bacterial cell wall synthesis, leading to bacterial cell death. This oral formulation offers a convenient and effective treatment option for various common infections, providing reliable coverage with a well-established safety profile. Its extended half-life allows for less frequent dosing, enhancing patient adherence and therapeutic outcomes.
Features
- Broad-spectrum third-generation cephalosporin antibiotic
- Available in oral formulations including tablets, chewable tablets, and oral suspension
- Demonstrated efficacy against β-lactamase producing strains
- High bioavailability with rapid absorption following oral administration
- Stable in the presence of many bacterial β-lactamases
- Convenient once or twice-daily dosing regimen
Benefits
- Effectively treats respiratory tract infections including bronchitis and pneumonia
- Provides reliable coverage for urinary tract infections caused by susceptible organisms
- Successfully manages otitis media in pediatric populations
- Offers convenient oral administration alternative to parenteral antibiotics
- Demonstrates excellent tissue penetration at infection sites
- Maintains activity against many penicillin-resistant strains
Common use
Cefixime is commonly prescribed for the treatment of acute bacterial exacerbations of chronic bronchitis, community-acquired pneumonia, acute otitis media, uncomplicated urinary tract infections, and uncomplicated gonorrhea. It is particularly valuable in treating infections caused by Haemophilus influenzae, including β-lactamase producing strains, Streptococcus pneumoniae, Moraxella catarrhalis, Escherichia coli, Proteus mirabilis, and Neisseria gonorrhoeae. The medication is also used off-label for certain cases of Lyme disease and salmonella infections when oral therapy is appropriate.
Dosage and direction
The recommended adult dosage for most infections is 400 mg daily, administered as a single dose or in two divided doses of 200 mg every 12 hours. For uncomplicated gonococcal infections, a single 400 mg dose is typically prescribed. Pediatric dosing is based on weight, generally 8 mg/kg/day administered either once daily or in two divided doses. The oral suspension should be shaken well before each use. Cefixime may be taken with or without food, though administration with food may enhance tolerance in some patients. Treatment duration typically ranges from 7 to 14 days depending on the infection type and severity.
Precautions
Patients should complete the full course of therapy even if symptoms improve to prevent development of resistant bacteria. Use with caution in patients with renal impairment; dosage adjustment is recommended for creatinine clearance less than 60 mL/min. Monitor for signs of superinfection or pseudomembranous colitis during and after treatment. Exercise caution in patients with history of gastrointestinal disease, particularly colitis. Prolonged use may result in overgrowth of nonsusceptible organisms. Patients should be advised that antibacterial drugs including cefixime should only be used to treat bacterial infections.
Contraindications
Cefixime is contraindicated in patients with known hypersensitivity to cefixime, other cephalosporins, or any component of the formulation. Cross-sensitivity with penicillin antibiotics may occur; contraindicated in patients with history of severe hypersensitivity reactions to penicillins. Not recommended for patients with known anaphylactic reactions to β-lactam antibiotics. Contraindicated in patients with previous episodes of antibiotic-associated colitis.
Possible side effect
Common adverse reactions include gastrointestinal disturbances such as diarrhea (16%), nausea (7%), abdominal pain (3%), and dyspepsia (3%). Dermatological reactions including rash (3%) and pruritus may occur. Less frequent side effects include headache (2%), dizziness, vaginal candidiasis, and transient elevations in liver enzymes. Serious but rare adverse effects include pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylactic reactions, and blood dyscrasias including thrombocytopenia and neutropenia.
Drug interaction
Probenecid may decrease renal excretion of cefixime, potentially increasing serum concentrations. Concurrent use with carbamazepine may increase carbamazepine levels, requiring monitoring. May enhance the anticoagulant effect of warfarin; monitor prothrombin time. Concomitant use with potent diuretics may increase the risk of nephrotoxicity. Antacids containing aluminum or magnesium may reduce absorption rate but not overall extent of absorption. Caution advised when administering with other nephrotoxic medications.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Maintaining consistent blood levels is important for therapeutic efficacy, so patients should strive to adhere to the prescribed dosing regimen. If multiple doses are missed, contact healthcare provider for guidance.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric distress, diarrhea, and convulsions. Serum levels of cefixime can be reduced by hemodialysis or peritoneal dialysis. Treatment should be symptomatic and supportive. In cases of significant overdose, particularly with convulsions, consider administration of benzodiazepines. Monitor renal function and provide adequate hydration. There is no specific antidote for cefixime overdose. Contact poison control center for latest recommendations.
Storage
Store tablets at controlled room temperature 20°C to 25°C (68°F to 77°F) in a tight, light-resistant container. Keep oral suspension refrigerated between 2°C to 8°C (36°F to 46°F); discard unused portion after 14 days. Protect from excessive moisture and light. Keep all medications out of reach of children and pets. Do not freeze the oral suspension. Do not store in bathroom cabinets where moisture and temperature fluctuations may affect stability.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any new medication or treatment. The prescribing physician should be consulted regarding dosage adjustments based on individual patient factors. This information may not include all possible uses, directions, precautions, or interactions. Healthcare providers should reference the complete prescribing information before administering cefixime.
Reviews
Clinical studies demonstrate cefixime’s efficacy with cure rates exceeding 90% for uncomplicated urinary tract infections and 85-95% for respiratory tract infections. Medical professionals appreciate its convenient dosing schedule and reliable coverage against common pathogens. Patients report high satisfaction with the once-daily regimen and generally good tolerance. Some reviews note gastrointestinal side effects as the most common reason for discontinuation. The medication maintains consistently positive evaluations for its effectiveness in treating susceptible bacterial infections when used appropriately according to culture and sensitivity results when available.