Cefixime is a third-generation oral cephalosporin antibiotic renowned for its broad-spectrum activity against gram-negative and gram-positive bacteria. It functions by inhibiting bacterial cell wall synthesis, leading to bacterial cell death. This medication is particularly valued for its once-daily dosing convenience and high bioavailability, making it a preferred choice for treating a variety of community-acquired infections. Its stability against beta-lactamases enhances its efficacy where other antibiotics may fail.

Features

• Active ingredient: Cefixime (as trihydrate or other salt forms)
• Drug class: Third-generation cephalosporin antibiotic
• Administration: Oral (tablets, chewable tablets, oral suspension)
• Available strengths: 200 mg, 400 mg tablets; 100 mg/5 mL suspension
• Prescription status: Prescription-only medication
• Mechanism of action: Inhibition of bacterial cell wall synthesis

Benefits

• Effective against a wide range of gram-positive and gram-negative pathogens
• Convenient once-daily dosing regimen improves patient adherence
• High oral bioavailability ensures reliable systemic absorption
• Demonstrated clinical efficacy in respiratory, urinary, and ENT infections
• Generally well-tolerated with a favorable safety profile
• Suitable for both adult and pediatric populations (≥6 months)

Common use

Cefixime is commonly prescribed for the treatment of acute bacterial exacerbations of chronic bronchitis, community-acquired pneumonia, acute otitis media, pharyngitis, tonsillitis, and uncomplicated urinary tract infections. It is particularly effective against Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes, and susceptible strains of Escherichia coli.

Dosage and direction

Adults: 400 mg once daily or 200 mg every 12 hours
Pediatric patients (≥6 months): 8 mg/kg/day administered once daily or divided every 12 hours
Renal impairment: Dosage adjustment required for creatinine clearance <60 mL/min
Administration: May be taken with or without food; suspension should be shaken well before use

Precautions

• Use with caution in patients with history of gastrointestinal disease, particularly colitis
• Prolonged use may result in fungal or bacterial superinfection
• May cause false-positive reactions for glucose in urine using copper reduction tests
• Use in pregnancy only if clearly needed (Category B)
• Caution advised in nursing mothers as cefixime is excreted in human milk

Contraindications

• Known hypersensitivity to cefixime or other cephalosporin antibiotics
• Patients with history of severe hypersensitivity reactions to penicillins (cross-sensitivity may occur)
• Severe renal impairment without appropriate dosage adjustment

Possible side effect

Common adverse reactions include diarrhea (2.3%), nausea (1.8%), abdominal pain (1.4%), and headache (1.2%). Less frequently reported effects include dizziness, flatulence, and transient elevations in liver enzymes. Serious but rare side effects include pseudomembranous colitis, Stevens-Johnson syndrome, and anaphylactic reactions.

Drug interaction

• Probenecid may increase cefixime concentrations by reducing renal excretion
• May enhance the anticoagulant effect of warfarin
• Concurrent use with potent diuretics may increase the risk of nephrotoxicity
• Cholestyramine may reduce cefixime absorption

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintain the regular dosing schedule to ensure consistent therapeutic levels.

Overdose

Symptoms of overdose 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 in cases of significant overdose.

Storage

Store at room temperature (15-30°C/59-86°F) in a dry place protected from light and moisture. Keep the container tightly closed. Oral suspension remains stable for 14 days when refrigerated; discard any unused portion after this period. 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 before starting any new medication. The prescribing physician should be aware of the patient’s complete medical history and current medications. Individual response to therapy may vary.

Reviews

Clinical studies demonstrate cefixime’s efficacy with cure rates exceeding 85% in approved indications. Physicians appreciate its convenient dosing schedule and reliable coverage against common pathogens. Patients report high satisfaction with the once-daily regimen and generally good tolerability. Some clinicians note the importance of monitoring for gastrointestinal side effects, particularly in prolonged courses.