Cefixime

Indications

Cefixime is used for: 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

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 Powder for Suspension & DS Powder for Suspension: 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.

Contra Indications

Hypersensitivity to cephalosporin.

Precautions

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

Pregnancy-Lactation

Interactions

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

Adverse Effects

Side effects of Cefixime : >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.

Mechanism 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.