Cefixime

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Generic Name of Cefixime - Learn More

Cefixime

Cefixime Precaution - What You Need to Know

- Special Populations: Cefixime is a third-generation cephalosporin antibiotic and is classified as a pregnancy category B drug, meaning animal studies have not demonstrated harm to the fetus, but there are no well-controlled studies in pregnant women. Cefixime should only be used during pregnancy when the potential benefits justify the risks. It is excreted into breast milk in low concentrations, but it is generally considered safe for use in breastfeeding women. However, caution should be exercised when administering it to nursing mothers, especially if the infant is preterm or has a history of gastrointestinal or allergic issues.
- Renal Impairment: Since Cefixime is primarily excreted by the kidneys, it should be used with caution in patients with renal impairment. Dosage adjustments are necessary for patients with creatinine clearance (CrCl) less than 60 mL/min to prevent accumulation and potential toxicity.
- Monitoring Parameters: Monitoring of renal function is recommended for patients with pre-existing kidney conditions, as well as for those receiving prolonged treatment or at higher doses. Additionally, patients should be monitored for any signs of allergic reactions, especially those with a history of beta-lactam allergies.
- Misuse or Dependency: Cefixime does not carry a risk of misuse or dependency. However, inappropriate or overuse of antibiotics, including Cefixime, can contribute to the development of antibiotic-resistant bacteria. Patients should be instructed to complete the full course of therapy, even if they feel better, to prevent resistance.

Cefixime Indication - Uses and Benefits

- Primary Indications: Cefixime is indicated for the treatment of various bacterial infections, including:
- Uncomplicated urinary tract infections (UTIs)
- Otitis media (middle ear infections)
- Pharyngitis/tonsillitis
- Gonorrhea
- Community-acquired pneumonia (CAP)
- Evidence-Based Context: Cefixime is effective against a wide range of Gram-negative and Gram-positive bacteria. It is commonly used as a first-line treatment for uncomplicated UTIs caused by *Escherichia coli*, *Proteus mirabilis*, and *Klebsiella pneumoniae*, as well as for upper respiratory tract infections caused by *Streptococcus pneumoniae* and *Haemophilus influenzae*. Clinical guidelines suggest Cefixime for treating infections such as otitis media, as it is effective against common pathogens.
- Off-label Uses: While Cefixime is primarily used for the infections listed above, it may also be used off-label to treat other bacterial infections, including certain skin and soft tissue infections, as well as some cases of atypical pneumonia. However, its use should be guided by local susceptibility patterns and individual patient factors.

Cefixime Contraindications - Important Warnings

- Exclusion Criteria: Cefixime is contraindicated in patients who have a known hypersensitivity to cephalosporins, penicillins, or any of the drug's components. It should be avoided in individuals who have experienced severe allergic reactions, such as anaphylaxis, to beta-lactam antibiotics.
- Rationale: The primary contraindication is due to the risk of severe hypersensitivity reactions, which could be life-threatening. Patients with a history of anaphylactic reactions to penicillin or other cephalosporins are at higher risk for a similar reaction to Cefixime.
- Age and Demographic Considerations: Cefixime is generally safe for adults and children older than 6 months. However, in children younger than 6 months, the safety and efficacy of Cefixime have not been established. Additionally, elderly patients may require dose adjustments, especially those with renal impairment.

Cefixime Side Effects - What to Expect

- Common Side Effects: The most common side effects associated with Cefixime include mild gastrointestinal disturbances such as diarrhea, nausea, and abdominal discomfort. Headache and dizziness may also occur, but these are typically transient.
- Serious Side Effects: Serious adverse effects are rare but can include severe allergic reactions, including anaphylaxis, as well as blood disorders such as thrombocytopenia, neutropenia, and hemolytic anemia. In patients with renal impairment or those on high doses, neurotoxic effects such as confusion, seizures, or encephalopathy may occur. Additionally, long-term use can lead to Clostridium difficile-associated diarrhea, which can result in severe colitis.
- Mitigation and Monitoring: To reduce gastrointestinal side effects, patients should take Cefixime with food. If signs of severe allergic reactions, blood disorders, or gastrointestinal issues (e.g., watery or bloody diarrhea) occur, patients should stop the drug immediately and seek medical attention. Regular blood tests may be required for patients on prolonged therapy or those at risk of hematological complications.

Cefixime Pregnancy Category ID - Safety Information

2

Cefixime Mode of Action - How It Works

- Mechanism: Cefixime is a cephalosporin antibiotic that works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) on the bacterial cell membrane, which are responsible for the cross-linking of peptidoglycan, a structural component of the bacterial cell wall. Without a properly functioning cell wall, bacteria become unstable and eventually undergo lysis.
- Pharmacodynamics and Pharmacokinetics: Cefixime is bactericidal, meaning it kills bacteria rather than merely inhibiting their growth. It has a broad spectrum of activity against both Gram-positive and Gram-negative organisms. After oral administration, Cefixime is well absorbed and reaches peak plasma concentrations within 2 to 6 hours. It has a half-life of approximately 3 to 4 hours, and about 50-60% of the drug is excreted unchanged in the urine.
- Distinctive Action: Cefixime is effective against a wide range of pathogens, including *Escherichia coli*, *Haemophilus influenzae*, *Streptococcus pneumoniae*, and *Klebsiella pneumoniae*, making it useful for treating infections of the respiratory and urinary tracts. Its resistance to beta-lactamase enzymes produced by certain bacteria further enhances its clinical utility.

Cefixime Drug Interactions - What to Avoid

- Drug-Drug Interactions: Cefixime can interact with certain medications. For example, the use of Cefixime with other nephrotoxic agents (e.g., aminoglycosides like gentamicin or diuretics like furosemide) can increase the risk of kidney damage. There is also a potential interaction with probenecid, which may increase the plasma levels of Cefixime by inhibiting its renal excretion.
- Food and Alcohol Interactions: Cefixime can be taken with or without food. However, taking it with food can enhance absorption and reduce the likelihood of gastrointestinal side effects. While no significant interactions exist between Cefixime and alcohol, patients should avoid excessive alcohol intake during antibiotic therapy to prevent gastrointestinal discomfort.
- Clinical Recommendations: To minimize the risk of nephrotoxicity, Cefixime should be used cautiously in combination with nephrotoxic drugs. If used with probenecid, the dose of Cefixime may need to be reduced to prevent excessive plasma levels. Patients should be counseled on the importance of completing their full course of antibiotics, even if symptoms improve before finishing the medication.

Cefixime Adult Dose - Recommended Dosage

- Standard Dosage: The usual adult dose of Cefixime for treating infections like uncomplicated urinary tract infections, otitis media, or pharyngitis is 400 mg once daily or 200 mg twice daily. For gonorrhea, a single dose of 400 mg is recommended.
- Administration: Cefixime is typically taken orally in tablet or liquid form. It is recommended to take Cefixime with food to improve absorption and reduce gastrointestinal irritation.
- Maximum Dosage: The maximum recommended dose of Cefixime is generally 400 mg per day, but for severe infections or complicated cases, a dose adjustment or different antibiotic may be considered.

Cefixime Child Dose - Dosage for Children

- Pediatric Dosing: For children aged 6 months and older, the typical dose of Cefixime for infections like otitis media or urinary tract infections is 8 mg/kg/day, divided into two doses. The maximum dose should not exceed 400 mg per day.
- Safety and Efficacy: Cefixime is generally safe and effective for treating bacterial infections in children, particularly those caused by common pathogens like *Streptococcus pneumoniae* and *Haemophilus influenzae*. Dosing should be based on the child’s weight to ensure appropriate therapeutic levels.
- Pediatric Monitoring: Pediatric patients should be monitored for signs of gastrointestinal disturbances or allergic reactions. For those with renal impairment, careful dosing adjustments are necessary to avoid toxicity.

Cefixime Renal Dose - Dosage for Kidney Conditions

- Renal Impairment: In patients with renal dysfunction, the dosage of Cefixime should be adjusted based on the degree of impairment to avoid drug accumulation. For patients with creatinine clearance (CrCl) less than 60 mL/min, the usual dose of 400 mg should be reduced or given every other day.
- Monitoring Recommendations: Renal function should be monitored during treatment, especially for patients with existing kidney conditions. Dosage modifications are necessary if renal function declines during therapy.