Medication Guide for Cefixime

Drug Classification

Cefixime is classified as a third-generation cephalosporin antibiotic. It exhibits broad-spectrum antibacterial activity.

Mechanism of Action

Cefixime works by inhibiting bacterial cell wall synthesis. This leads to bacterial cell lysis and subsequent death. The drug is highly effective against Gram-negative organisms and certain Gram-positive organisms.

Indications for Use

Cefixime is prescribed for the treatment of various bacterial infections. Indications include uncomplicated urinary tract infections (UTIs), otitis media, pharyngitis, bronchitis, and gonococcal infections.

Formulations Available

Cefixime is available in various formulations. These include oral tablets, capsules, chewable tablets, and oral suspension. Each formulation allows for different modes of administration based on patient needs.

Dosage Recommendations

The standard adult dosage of Cefixime is 400 mg daily. This can be administered as a single dose or divided into two doses. Pediatric dosing is typically based on the child’s weight and the severity of the infection.

Administration Guidelines

For optimal absorption, Cefixime should be taken with food. Chewable tablets must be thoroughly chewed before swallowing. The oral suspension should be shaken well before use to ensure a uniform mixture.

Pharmacokinetics

After oral administration, Cefixime is absorbed with a bioavailability of 40–50%. Peak plasma concentrations are reached within 2 to 6 hours. The drug is primarily excreted unchanged in the urine.

Specific Populations

In renal impairment, dosage adjustments are necessary due to reduced clearance of Cefixime. Geriatric patients may also require dosage modifications. The safety and efficacy in neonates have not been established.

Drug Interactions

Cefixime may interact with certain medications, affecting its efficacy. Probenecid can increase plasma levels of Cefixime. Antacids containing magnesium or aluminum interfere with the absorption of Cefixime.

Adverse Reactions

Common adverse reactions include gastrointestinal disturbances like diarrhea, nausea, and abdominal pain. Hypersensitivity reactions such as rash, pruritus, and fever may occur. Long-term use can lead to superinfection.

Monitoring Parameters

Monitoring of renal function is advised, especially in patients with preexisting renal impairment. Any signs of antibiotic-associated colitis should be promptly evaluated. Blood counts may be monitored if the treatment duration extends beyond two weeks.

Storage Instructions

Cefixime tablets and capsules should be stored at room temperature, away from moisture and heat. The oral suspension should be kept in a refrigerator and discarded after 14 days from reconstitution.

Suitable Substitutes

Suitable substitutes for Cefixime include other third-generation cephalosporins like Cefdinir and Cefpodoxime. Substitutions should be made based on bacterial sensitivity and patient tolerance.

Brand Names

Common brands of Cefixime include Suprax and Cefspan. Different manufacturers may market the drug under various brand names globally

Pharmacodynamics

Cefixime exhibits a time-dependent killing mechanism. Its efficacy is closely tied to the duration that drug concentrations exceed the minimum inhibitory concentration (MIC) for the pathogens involved.

Pediatric Considerations

In children, appropriate formulations like chewable tablets or oral suspension are often preferred. Dosage is typically calculated based on body weight, commonly at 8 mg/kg/day.

Geriatric Use

While dosage adjustment may not always be necessary, geriatric patients should be monitored closely for renal function. Reduced renal function may affect drug clearance and necessitate dosage changes.

Visual Identification

Cefixime tablets are typically white or off-white and may be round or oval. Capsules often have distinctive markings for easy identification.

Therapeutic Use Specifics

In treating otitis media, Cefixime is particularly useful due to its activity against Hemophilus influenzae. For gonorrhea, a single 400 mg dose is effective in uncomplicated cases.

Diagnostic Tests Interference

Cefixime can interfere with certain diagnostic tests. A false-positive result for glucose in the urine may occur. Tests involving ferricyanide need consideration when patients are on Cefixime.

Cost and Availability

Cefixime is generally affordable and widely available. However, costs may vary based on brand, formulation, and regional pricing. Generic versions offer a more cost-effective option.

Patient Counseling

Patients should be informed about the importance of completing the full course of therapy. Instructions on proper administration, especially for pediatrics, should be emphasized to ensure adherence.

Allergic Reactions

Patients with a history of hypersensitivity to cephalosporins should avoid Cefixime. Cross-sensitivity with penicillins may occur, and detailed patient history is crucial for safe prescription.

Resistance Considerations

Repeated or inappropriate use of Cefixime can contribute to the development of antibiotic-resistant bacteria. It’s essential to prescribe this medication based on culture and sensitivity results when available.

Patient Education Materials

Providing written education materials about Cefixime can enhance patient understanding and compliance. Information should cover dosage, common side effects, and the importance of adherence.

Professional Resources

Healthcare providers can access professional resources like medical databases and journals for the latest research on Cefixime. Participation in continuing education ensures up-to-date knowledge on antibiotic therapy.