Generic Name

Cefixime

Precaution

History of allergy to penicillins; pregnancy, lactation; renal failure; GI disease. Lactation: Unknown whether drug is excreted in milk

Indication

Pneumonia, Pharyngitis, Typhoid fever, Susceptible infections , Sinusitis, Otitis media, Tonsillitis, Soft tissue infections, Respiratory tract infections, Acute Exacerbations of Chronic bronchitis, Gonococcal urethritis, Acute bronchitis

Contra Indication

Hypersensitivity to cephalosporin.

Dose

N/A

Side Effect

>10% Diarrhea (16%) Frequency Not Defined Abdominal pain,Candidiasis,Dizziness,Dyspepsia,Elevated transaminases,Eosinophilia,Erythema multiforme,Fever,Flatulence,Headache,Increased blood urea nitrogen (BUN),Increased creatinine,Leukopenia,Nausea,Prolonged prothrombin time (PT),Pruritus,Pseudomembranous colitis,Rash,Serum sickness-like reaction,Stevens-Johnson syndrome,Thrombocytopenia,Urticaria,Vaginitis,Vomiting Potentially Fatal: Pseudomembranous colitis.

Pregnancy Category

Mode of Action

Cefixime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Interaction

Increased concentrations with probenecid. Potentially Fatal: May increase prothrombin time with anticoagulants.

Pregnancy Category Note

Pregnancy Available data from published observational studies, case series, and case reports over several decades with cephalosporin use, including cefixime, in pregnant women have not established drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes Maternal gonorrhea may be associated with preterm birth, low neonatal birth weight, chorioamnionitis, intrauterine growth restriction, small for gestational age and premature rupture of membranes; perinatal transmission of gonorrhea to offspring can result in infant blindness, joint infections, and bloodstream infections Lactation There are no available data on presence of drug in human milk, effects on breastfed infant, or on milk production; drug is present in animal milk; when a drug is present in animal milk, it is likely the drug will be present in human milk; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from mother’s underlying condition

Adult Dose

Acute Bronchitis & Acute Exacerbations of Chronic Bronchitis, Otitis Media, Pharyngitis/Tonsillitis, Uncomplicated Urinary Tract Infections Adult: 200 or 400 mg daily as a single dose or in two divided doses Gonorrhea: 400 mg as a single dose. Typhoid fever: 20 mg/kg body weight daily in two divided dose. The usual treatment of is 7 days. This may be continued for up to 14 days according to the severity of infection.

Child Dose

Child: PO 8 mg/kg/day if <50 kg q12–24h For convalescent oral therapy of serious infections, up to 20 mg/kg/day Child over 12 years: Capsule: 200 or 400 mg daily as a single dose or in two divided doses Powder for Suspension & DS Powder for Suspension & Paediatric Drops: Children above 6 months: 8 mg/kg daily in 1-2 divided doses or 6 months-1year: 75 mg daily 1-4 years: 100 mg daily 5-10 years: 200 mg daily Typhoid Fever 15-20 mg/kg/day PO divided q12hr for 7-14 days; not to exceed 400 mg/day <6 months: Safety and efficacy not established

Renal Dose

Renal impairment: Dose reduction is necessary. CrCl (ml/min) <20 Max: 200 mg daily.

Administration

May be taken with or without food. May be taken w/ food or milk to reduce GI discomfort.