Cefixime: Potent Broad-Spectrum Antibiotic Therapy
Cefixime is a third-generation cephalosporin antibiotic with exceptional activity against Gram-negative bacteria, including many β-lactamase-producing strains. It demonstrates superior pharmacokinetic properties with high oral bioavailability and prolonged serum half-life, enabling convenient once-daily dosing. This antibiotic is particularly valuable for treating respiratory, urinary, and ENT infections where resistant pathogens are suspected, providing clinicians with a reliable empiric therapy option.
Features
- Third-generation cephalosporin antibiotic class
- Broad-spectrum activity against Gram-negative and Gram-positive organisms
- Stable against many β-lactamase enzymes
- High oral bioavailability (>40%)
- Extended half-life (3-4 hours) permitting once-daily dosing
- Available as tablets, chewable tablets, and oral suspension formulations
- Demonstrated efficacy against Haemophilus influenzae, including β-lactamase-producing strains
Benefits
- Effective treatment for resistant bacterial infections through β-lactamase stability
- Convenient dosing regimen improves patient compliance and adherence
- Comprehensive coverage of common community-acquired pathogens
- Reduced treatment duration compared to some alternative antibiotics
- Well-tolerated profile with generally mild adverse effects
- Suitable for both adult and pediatric populations (≥6 months)
Common use
Cefixime is indicated for the treatment of infections caused by susceptible strains of designated microorganisms, including acute bacterial exacerbations of chronic bronchitis due to Streptococcus pneumoniae and Haemophilus influenzae, otitis media caused by H. influenzae, Moraxella catarrhalis, and Streptococcus pyogenes, pharyngitis and tonsillitis attributable to Streptococcus pyogenes, uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis, and uncomplicated gonorrhea caused by Neisseria gonorrhoeae.
Dosage and direction
The recommended dosage varies based on infection type and patient factors. For most infections in adults and children ≥12 years or ≥50 kg: 400 mg daily. For otitis media in children 6 months through 12 years: 8 mg/kg/day. For pharyngitis and tonsillitis in children: 8 mg/kg/day. Administration may occur with or without food, though food may enhance absorption. Tablets should be swallowed whole; the oral suspension must be shaken well before each use. Complete the full prescribed course even if symptoms improve earlier.
Precautions
Use with caution in patients with renal impairment (dosage adjustment required for creatinine clearance <60 mL/min). Monitor for superinfection or pseudomembranous colitis during and after treatment. Exercise caution in patients with history of gastrointestinal disease, particularly colitis. May result in false-positive urinary glucose tests when using copper reduction methods. Prolonged use may result in fungal or bacterial superinfection, including antibiotic-associated colitis.
Contraindications
Known hypersensitivity to cefixime, other cephalosporins, or any component of the formulation. Cross-sensitivity with penicillins may occur in up to 10% of patients with penicillin allergy. Avoid use in patients with history of severe hypersensitivity reactions to other β-lactam antibiotics.
Possible side effect
Common adverse reactions include diarrhea (16%), nausea (7%), abdominal pain (3%), dyspepsia (3%), and flatulence (4%). Less frequent effects include headache, dizziness, transient elevations in liver enzymes, and vaginal candidiasis. Serious but rare side effects include pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and anaphylactic reactions.
Drug interaction
Probenecid may increase and prolong cefixime blood levels. May enhance anticoagulant effect of warfarin. Concurrent use with carbamazepine may increase carbamazepine levels. May reduce efficacy of oral contraceptives; recommend additional contraceptive methods. Potential interaction with chloramphenicol (antagonistic effect in vitro).
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for the missed one. Maintain regular dosing intervals to ensure consistent therapeutic blood levels.
Overdose
Symptoms may include nausea, vomiting, epigastric distress, and diarrhea. Gastric lavage may be considered if administered soon after ingestion. No specific antidote exists; treatment should be symptomatic and supportive. Hemodialysis may enhance elimination of cefixime in cases of significant overdose.
Storage
Store tablets at controlled room temperature (20-25°C/68-77°F). Keep oral suspension refrigerated (2-8°C/36-46°F) and discard unused portion after 14 days. Keep all formulations in their original container, tightly closed, and protected from light and moisture. Keep out of reach of children.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment recommendations. Dosage and administration should be determined by a physician based on individual patient characteristics and local susceptibility patterns.
Reviews
Clinical studies demonstrate cefixime’s efficacy with cure rates of 82-95% for respiratory tract infections and 85-97% for urinary tract infections. Physicians report excellent patient tolerance and compliance with the once-daily regimen. Microbiological studies confirm maintained activity against common pathogens, though emerging resistance patterns require ongoing surveillance. The oral suspension formulation receives particular praise for its acceptability in pediatric populations.