Cefixime + Clavulanic acid

Indications

Cefixime + Clavulanic acid is used for: Pharyngitis, Acute otitis media, Community-acquired pneumonia, Sinusitis, UTI, Cystitis, Gonorrhea, Skin and skin structure infections, Tonsillitis, Respiratory tract infections, Acute Maxillary Sinusitis, Acute bacterial exacerbation of chronic bronchitis, Enteric fever

Adult Dose

Adult: PO Resp tract infections; UTI 100-200 mg 12 hrly. Skin infections 200-400 mg 12 hrly. Uncomplicated gonorrhoea 200 mg as a single dose.

Child Dose

Child : PO 10 mg/kg/day, max 400 mg/day q12h 6 months - 2 years : 40 mg every 12 hours 3 - 8 years : 80 mg every 12 hours over 9 years : 100 mg every 12 hours

Renal Dose

Renal impairment: Patients on haemodialysis: Dose should be given after each dialysis session. CrCl (ml/min) Dosage Recommendation 10-39 Increase dosing intervals to 24 hrly. <10 Increase dosing intervals to 48 hrly.

Administration

Should be taken with food. Take after meals.

Contra Indications

Hypersensitivity to cephalosporins.

Precautions

History of allergy to penicillin; severe renal impairment; pregnancy and lactation. Lactation: Drug excreted in breast milk in low concentrations; not recommended

Pregnancy-Lactation

Interactions

Antacids or H2-blockers may decrease the absorption of cefpodoxime. Reduced renal excretion w/ probenecid.

Adverse Effects

Side effects of Cefixime + Clavulanic acid : >10% Diarrhea in infants and toddlers (15.4%),Diaper rash (12.1%) 1-10% Diarrhea (7.4%),Nausea (3.8%),Vaginal infection (3.1%),Vomiting (1.1-2.1%),Abdominal pain (1.6%),Rash (1.4%),Headache (1.1%) Potentially Fatal: Pseudomembranous colitis; nephrotoxicity.

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. Addition of clavulanate inhibits beta-lactamase-producing bacteria; Clavulanic acid has a high affinity for and binds to certain ?-lactamases that generally inactivate Cefuroxime by hydrolyzing its ?-lactam ring. Combining clavulanate potassium with Cefuroxime extends the antibacterial spectrum of Cefuroxime to include many bacteria normally resistant to Cefuroxime and other penicillins and cephalosporins.