Cefixime: A third generation oral cephalosporin

Name of drug

Cefixime is an antibiotic used to treat a variety of bacterial infections. It is one of the most commonly used antibiotics.

Class of drug

Cefixime belongs to a class of drugs called antibiotics. It is cephalosporin antibiotic. It is a third generation cephalosporin antibiotic. Cephalosporins are a group of semisynthetic antibiotics derived from ‘cephalosporin-C’ obtained from a fungus Cephalosporium.

Used for

Cefixime is used to treat various bacterial infections. It is an antibiotic. It is used to treat the following conditions.

  • Tonsillitis/pharyngitis: It is used to treat tonsillitis pharyngitis caused by susceptible Streptococcus pyogenes and Haemophilus influenzae.
  • Otitis media: It is a condition in which middle ear infection occurs. It is caused by many bacterial infections. Cefixime is used if it is caused by susceptible bacterias of H. influenzae or Streptococcus pyogenes.
  • Uncomplicated gonorrhea: Gonorrhoea is a bacterial infection of genitals caused by Neisseria gonorrhoeae. It is a sexually transmitted disease caused by unprotected sex. Cefixime is used to treat uncomplicated cases of gonorrhea.
  • Urinary tract infections are caused by E. coli and Proteus mirabilis. Uncomplicated urinary tract infections like cystitis and urethritis that are caused by susceptible bacteria on urine culture can be treated with cefixime.
  • Typhoid fever: Cephalosporins are effective antibiotics to treat typhoid fever. Cefixime can be used to treat typhoid fever. Typhoid fever is caused by bacterial infections of Salmonella typhi and paratyphi.
  • Lower respiratory tract infections caused by susceptible strains of Streptococcus pneumoniae and H. influenzae can be treated with cefixime.

Mechanism of action

Cefixime is a cephalosporin of the third generation. Third generation cephalosporins are highly active against gram negative enterococci. Cefixime is active against Enterobacteria, Haemophilus influenzae and Streptococcus pyogenes. Most of these bacteria are beta lactamase resistant. It is not active against Staphylococcus aureus and pneumococci and pseudomonas.

Cefixime like other cephalosporins stops bacteria forming their cell wall. It has a bactericidal effect. It gets incorporated in the beta lactam ring and stops formation of beta lactam ring. Beta lactam ring is essential for bacteria to form cell wall structure.

Available as

Cefixime is available as following forms:

Capsule of 400 mg

Tablets of 100 mg, 200 mg

Syrups of 50mg/5ml or 100mg/5ml

Drops of 50mg/ml

Administered as

Cefixime is administered at recommended doses orally as tablets, syrups or drops. Tablets can be swallowed with water. It also available as chew tab or dispersible tabs.

Pregnancy

Available data has not detected any adverse effect when used in pregnancy. Infact the conditions treated with cefixime like gonorrhea in pregnancy can cause fetal loss, abortions, preterm birth, premature rupture of mebranes.

Lactation

Cefixime is an antibiotic that can be safely used in a lactating mother who is breastfeeding her baby.

Elderly

Cefixime can be safely used in elderly people without any increased side effects in this age group.

Liver failure

Transient rise of various liver enzymes has been observed with use of cephalosporins including cefixime. It should be used cautiously in cases of liver failure.

Kidney failure

As with other cephalosporins, cefixime may cause acute renal failure including tubulointerstitial nephritis as an underlying pathological condition. When acute renal failure occurs, cefixime should be discontinued and appropriate therapy and/or measures should be taken.

Side effects

Like any other medicine cefixime too causes side effects. They as as follows:

  • Diarrhea is the most common side effect caused by cefixime. It can be due to antibiotic associated diarrhea. It can be treated with probiotics and metronidazole.
  • Dizziness.
  • Fatigue.
  • Fever.
  • Flatulence.
  • Dyspepsia.
  • Headache.
  • Increased creatinine and blood urea nitrogen.
  • Nausea and vomiting.
  • Decreased leukocyte count.
  • Pseudomembranous colitis.
  • Steven Johnson syndrome.

Usual drug dosages

Drug dosages and duration depends upon underlying conditions for which it is used.

  • Adult dosages: 

400 mg single daily dose given orally or 200 mg twice a day dose given orally.

  • Children: 

6-12 years 8 mg/kg/day orally in 2 divided doses. (Maximum 400 mg daily.

For children > 12 years old 400 mg once a day orally or 200 mg twice a day orally




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