Indications
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)
Otitis Media
Typhoid
Urinary Tract Infections
Uncomplicated gonorrhea (cervical/urethral).
Therapeutic Class
Third generation Cephalosporins
Pharmacology
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.
Usual dose:
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
Gonorrhoea:
Adult: 400-800 mg as a single dose
Interaction
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.
Contraindications
Patients with known hypersensitivity to cephalosporin antibiotics, children under 6 months.
Side Effects
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.
Reviews
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