Cefixime is a third-generation cephalosporin antibiotic designed to combat a wide range of bacterial infections with high efficacy and convenient once-daily dosing. It works by inhibiting bacterial cell wall synthesis, leading to the eradication of susceptible pathogens. This medication is commonly prescribed for respiratory, urinary tract, and ear infections, offering a reliable treatment option for both adults and children. Its broad-spectrum activity and oral bioavailability make it a preferred choice in outpatient settings.

Features

• Active ingredient: Cefixime
• Drug class: Third-generation cephalosporin antibiotic
• Administration: Oral tablet or suspension
• Available strengths: 200 mg, 400 mg tablets; 100 mg/5 mL suspension
• Prescription required: Yes
• Half-life: Approximately 3–4 hours
• Excretion: Primarily renal

Benefits

• Effectively treats a broad spectrum of Gram-positive and Gram-negative bacterial infections
• Convenient once-daily dosing improves patient adherence
• Well-tolerated with a favorable safety profile for most patient populations
• Suitable for pediatric use in suspension form
• Rapid onset of action with clinical improvement often observed within 48–72 hours
• Lower risk of Clostridium difficile-associated diarrhea compared to some broader-spectrum antibiotics

Common use

Cefixime is indicated for the treatment of infections caused by susceptible strains of designated microorganisms, including:

• Acute bacterial exacerbations of chronic bronchitis
• Acute community-acquired pneumonia
• Uncomplicated urinary tract infections (cystitis)
• Pharyngitis and tonsillitis
• Acute otitis media
• Uncomplicated gonorrhea (urethral and cervical)

Dosage and direction

Adults: The recommended dose for most infections is 400 mg orally once daily or divided as 200 mg every 12 hours. For uncomplicated gonorrhea, a single 400 mg dose is standard. Pediatric patients: 8 mg/kg/day orally, either as a single dose or divided every 12 hours (maximum 400 mg/day). Dosage adjustments are necessary for patients with renal impairment (creatinine clearance <60 mL/min). Tablets should be taken with food to enhance absorption; suspension may be taken with or without food. Complete the full prescribed course even if symptoms improve earlier.

Precautions

• Use with caution in patients with history of gastrointestinal disease, particularly colitis
• Renal function should be assessed before and during prolonged therapy
• May result in overgrowth of nonsusceptible organisms; monitor for superinfection
• Use in pregnancy only if clearly needed (Pregnancy Category B)
• Caution in breastfeeding women; cefixime is excreted in human milk
• False positive reactions for glucose in the urine may occur with Benedict’s or Fehling’s solutions

Contraindications

• Known hypersensitivity to cefixime, cephalosporins, or any component of the formulation
• Patients with history of severe allergic reactions to penicillins (cross-sensitivity may occur)
• Not recommended in patients with phenylketonuria (chewable tablets contain phenylalanine)

Possible side effect

Common adverse reactions (≥1%) include:

• Diarrhea (16%)
• Nausea (7%)
• Abdominal pain (3%)
• Headache (2%)
• Dyspepsia (1%) Less frequent but serious side effects requiring medical attention:
• Severe diarrhea or bloody stools (possible pseudomembranous colitis)
• Allergic reactions (rash, urticaria, anaphylaxis)
• Hepatitis or elevated liver enzymes
• Hematologic effects (eosinophilia, thrombocytopenia)
• Renal impairment

Drug interaction

• Probenecid: May increase and prolong cefixime blood levels
• Carbamazepine: Elevated carbamazepine levels reported
• Warfarin: Potential enhancement of anticoagulant effect
• Oral contraceptives: Possible reduced efficacy; recommend alternative contraception
• Nephrotoxic drugs (e.g., aminoglycosides): Increased risk of renal toxicity

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to catch up. Maintain the regular dosing schedule to ensure consistent antibiotic levels.

Overdose

Symptoms of overdose may include nausea, vomiting, epigastric distress, and diarrhea. Gastric lavage may be considered if ingestion was recent. No specific antidote exists; management should be supportive and include maintenance of hydration and electrolyte balance. Hemodialysis may remove cefixime from circulation.

Storage

Store at controlled room temperature (20–25°C/68–77°F). Keep container tightly closed. Protect from light and moisture. Suspension remains stable for 14 days after reconstitution when refrigerated; discard any unused portion after this period. Keep out of reach of children.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment recommendations. Dosage and indications may vary based on individual patient factors and local prescribing guidelines.

Reviews

Clinical studies demonstrate cefixime’s efficacy with cure rates of 85–95% for approved indications. Patient satisfaction surveys note convenience of dosing but report gastrointestinal side effects as the most common drawback. Healthcare providers appreciate its spectrum of activity and reliability in treating common community-acquired infections.