Cefixime is indicated in the following infectious diseases-
Respiratory Tract Infections: Pneumonia, Sinusitis, Pharyngitis and Tonsillitis, Acute Bronchitis and Acute Exacerbations of Chronic Bronchitis (AECB)
Urinary Tract Infections
Uncomplicated gonorrhea (cervical/urethral).
Third generation Cephalosporins
Cefixime binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Dosage & Administration
The usual course of treatment is 7 days. This may be continued for up to 14 days if required. The daily dose can be given in 1–2 divided doses.
Adult and child over 10 years: 200–400 mg daily
Child over 6 months: 8 mg/kg daily
6 months to 1 year: 75 mg (3.75 ml) daily,
1 to 4 years: 100 mg (5 ml) daily
5 to 10 years: 200 mg (10 ml) daily
Typhoid and paratyphoid :
Adult: 200 mg 12 hourly
Child: 10 mg/kg 12 hourly
Adult: 400-800 mg as a single dose
Increased prothrombin time (with or withot bleeding) with anticoagulants (e.g. warfarin). Increased plasma carbamazepine concentrations with concomitant use. Increased bioavailability with nifedipine. Increased serum concentration with probenecid.
Patients with known hypersensitivity to cephalosporin antibiotics, children under 6 months.
Cefixime is generally well tolerated. The majority of side-effects observed in clinical trials were mild and self-limiting in nature. Diarrhoea, stool changes, nausea, vomiting, abdominal pain, dyspepsia, headache and dizziness.
Pregnancy & Lactation
Pregnancy category B. There are no adequate and well-controlled studies in pregnant women. So this drug should be used during pregnancy only if clearly needed.
Use in Lactation: It is not known whether cefixime is excreted in human milk. So it is probably best either to avoid using the drug by the nursing mother or to discontinue breast feeding.
Patient with history of penicillin allergy. Renal impairment. Children. Pregnancy and lactation.
Symptoms: Mild to moderate adverse GI effects.
Management: Supportive treatment. Empty stomach by gastric lavage.
Use in Special Population
Use in Children: Safety and effectiveness of cefixime in children aged less than 6 months have not been established. For children younger than 12 years or weighing less than 50 kg, the usual dose is 8 mg/kg/day.
Use in elderly: No special precautions are necessary. Old age is not an indication for dose adjustment.
Dosage in renal impairment:
Creatinine clearance: 20 ml/min or greater: normal dose
Creatinine clearance: <20 ml/min or chronic ambulatory peritoneal dialysis Haemodialysis: daily dose should not exceed 200 mg. Storage Conditions Store in a cool and dry place below 30ºC