Cefixime

Upper respiratory tract infections; Lower respiratory tract infections; Urinary tract infections:
Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or haemodialysis: Max: 200 mg once daily.

CrCl (mL/min)	Dosage
<20	Max: 200 mg once daily.

Cefixime May be taken with or without food. May be taken w/ food or milk to reduce GI discomfort.

Powder for oral susp: Add the appropriate amount of water specified on the packaging in 2 portions. Shake well after each addition until contents are evenly suspended.

Hypersensitivity to cephalosporins.

Patient with history of hypersensitivity to penicillin and other beta-lactam antibiotics, poor nutritional state, history of gastrointestinal disease, particularly colitis. Renal and hepatic impairment. Children. Pregnancy and lactation.

Significant: Encephalopathy (including convulsion, confusion, impairment of consciousness, movement disorders), acute renal failure (including tubulointerstitial nephritis).
Blood and lymphatic system disorders: Transient thrombocytopenia, leucopenia, neutropenia, pancytopenia, agranulocytosis, eosinophilia.
Gastrointestinal disorders: Diarrhoea, loose or frequent stools, abdominal pain, nausea, vomiting, dyspepsia, flatulence.
Hepatobiliary disorders: Hepatitis, jaundice, hyperbilirubinaemia.
Immune system disorders: Hypersensitivity reactions including rash, pruritus, urticaria, drug fever.
Investigations: Transient elevations in SGPT, SGOT, alkaline phosphatase, BUN and creatinine; increased LDH. Rarely, prolonged prothrombin time.
Nervous system disorders: Headaches, dizziness, seizures.
Reproductive system and breast disorders: Genital pruritus, vaginitis, candidiasis.
Potentially Fatal: Severe cutaneous adverse reactions (SCARS) including toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), drug rash with eosinophilia and systemic symptoms (DRESS), and acute generalised exanthematous pustulosis (AGEP), haemolytic anaemia, pseudomembranous colitis, anaphylactic/anaphylactoid reactions (including shock).

PO: B

Monitor renal and hepatic functions periodically. Observe for signs and symptoms of anaphylaxis during 1st dose.

Symptoms: Encephalopathy including convulsion, confusion, impaired consciousness and movement disorders. Management: General supportive treatment.

May enhance the effects of anticoagulants (e.g. warfarin) resulting in prolonged prothrombin time. May increase carbamazepine levels.

May cause false-positive reaction for urinary glucose using Clinitest^®, Benedict’s solution, or Fehling’s solution; false-positive reaction for ketones in the urine with tests using nitroprusside; false-positive direct Coombs’ test.

Description:
Mechanism of Action: Cefixime is a 3rd generation cephalosporin with bactericidal activity. It binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell lysis and death.
Pharmacokinetics:
Absorption: Bioavailability: 22-54%. Time to peak plasma concenration: 2-6 hours (susp); 3-8 hours (cap).
Distribution: Crosses the placenta. Plasma protein binding: Approx 65%, mainly to albumin.
Excretion: Mainly via urine (approx 50% as unchanged drug); faeces (10%).

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 5362065, Cefixime. https://pubchem.ncbi.nlm.nih.gov/compound/5362065. Accessed Aug. 25, 2022.

Store between 20-25°C. Reconstituted powder for oral susp: Store between 2-8°C, stable for up to 14 days.

Cephalosporins

J01DD08 - cefixime ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.

Anon. Cefixime. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 13/07/2022.

Anon. Cefixime. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/07/2022.

Buckingham R (ed). Cefixime. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/07/2022.

Cefisal-200 200 mg Film-coated Tablet (Akums Drugs & Pharmaceuticals Ltd.). MIMS Philippines. http://www.mims.com/philippines. Accessed 13/07/2022.

Cefixime 100 mg/5 mL Powder for Oral Suspension (Generics UK Ltd t/a Mylan). MHRA. https://products.mhra.gov.uk. Accessed 13/07/2022.

Cefixime Capsule (Ascend Laboratories, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 13/07/2022.

Cefixime Powder for Suspension (Aurobindo Pharma Limited). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 13/07/2022.

Joint Formulary Committee. Cefixime. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/07/2022.

Suprax Tablet, Chewable (Lupin Pharma). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 13/07/2022.

Suprax Tablets 200 mg (Aventis Pharma Limited). MHRA. https://products.mhra.gov.uk. Accessed 13/07/2022.