Cefixime

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Therapeutic Class
3rd Generation Cephalosporin Antibiotic

Clinical Teaching

  • This drug may cause abdominal pain or nausea.
  • Instruct patient to report signs/symptoms serum-sickness-like reactions (rash, urticaria, arthralgia, fever, malaise, enlarged lymph nodes).
  • Advise patient to report severe diarrhea and consult healthcare professional prior to taking anti-diarrhea medicine. Other superinfection signs/symptoms should be reported as well.

Dosing - Adult
Acute infective exacerbation of chronic obstructive pulmonary disease: 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Bronchitis, acute: 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Gonorrhea: uncomplicated, 400 mg ORALLY as one-time dose
Gonorrhea: disseminated (after parenteral therapy), 400 mg ORALLY twice a day to complete at least one week of therapy
Otitis media: 400 mg ORALLY once a day or divided twice a day, depending on type and severity of infection
Pharyngitis: 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Tonsillitis: 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Urinary tract infectious disease, Uncomplicated: 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection

Dosing - Pediatric
Acute infective exacerbation of chronic obstructive pulmonary disease: (6 months to 12 years of age) 8 mg/kg/day ORALLY once a day or divided twice a day; depending on type and severity of infection
Acute infective exacerbation of chronic obstructive pulmonary disease: (over 50 kg or over 12 years of age) 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Bronchitis, acute: (6 months to 12 years of age) 8 mg/kg/day ORALLY once a day or divided twice a day; depending on type and severity of infection
Bronchitis, acute: (over 50 kg or over 12 years of age) 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Gonorrhea: uncomplicated (greater than 45 kg), 400 mg ORALLY as one-time dose
Otitis media: (6 months to 12 years of age) 8 mg/kg/day ORALLY once a day or divided twice a day; depending on type and severity of infection
Otitis media: (over 50 kg or over 12 years of age) 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Pharyngitis: (6 months to 12 years of age) 8 mg/kg/day ORALLY once a day or divided twice a day; depending on type and severity of infection
Pharyngitis: (over 50 kg or over 12 years of age) 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Tonsillitis: (6 months to 12 years of age) 8 mg/kg/day ORALLY once a day or divided twice a day; depending on type and severity of infection
Tonsillitis: (over 50 kg or over 12 years of age) 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection
Urinary tract infectious disease, Uncomplicated: (6 months to 12 years of age) 8 mg/kg/day ORALLY once a day or divided twice a day; depending on type and severity of infection
Urinary tract infectious disease, Uncomplicated: (over 50 kg or over 12 years of age) 400 mg ORALLY once a day or divided twice a day; depending on type and severity of infection.

Adverse Effects - Common
Dermatologic: Pruritus, Rash, Urticaria
Gastrointestinal: Abdominal pain, Diarrhea, Nausea
Mechanism of Action
Cefixime, a semisynthetic cephalosporin, is a broad-spectrum bactericidal agent that inhibits cell-wall synthesis and is highly stable in the presence of beta lactamases .
Mechanism of Action - Pharmacokinetics
3 h to 4 h but may range up to 9 h
Oral: time to peak concentration, 2 h to 6 h
Protein binding: approximately 65%
Renal: approximately 50% unchanged
Bioavailability: about 40% to 50%
Dialyzable: no (hemodialysis), no (peritoneal dialysis)
moderate renal impairment (creatinine clearance of 20 mL/min to 40 mL/min): prolonged to 6.4 h
Effect of food: increases maximal absorption by approximately 0.8 h
severe renal impairment (creatinine clearance of 5 mL/min to 20 mL/min): increases to 11.5 h

Toxicology - Clinical Effects
CEPHALOSPORINS: OVERDOSE: Acute ingestion of large doses of cephalosporins may result in nausea, vomiting, diarrhea, and abdominal pain. Seizures have developed after parenteral overdose. ADVERSE EFFECTS: COMMON: Hypersensitivity reactions, including anaphylaxis, may commonly occur with therapy; oral exposures are less likely to cause severe allergic reactions than parenteral exposures. Seizures have also been reported following therapeutic administration. Prolonged prothrombin times, thrombocytopenia, and coagulopathies associated with a qualitative platelet defect and aggregation abnormalities have been reported following IV cephalosporin therapy. Pseudocholelithiasis may follow intravenous administration of ceftriaxone. Several cases of fatal hemolytic reactions following intravenous ceftriaxone therapy have been reported in children with serious hematologic abnormalities.

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