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Indications/Uses
For the treatment of the following infections due to susceptible microorganisms: Acute bronchitis, acute exacerbations of chronic bronchitis, bronchiectasis with infection, secondary infections in chronic respiratory tract diseases, pneumonia.
Urinary tract infections including pyelonephritis, cystitis and cystourethritis.
Uncomplicated gonorrhea (cervical/urethral).
Cholecystitis, cholangitis.
Scarlet fever.
Sinusitis, tonsilitis, pharyngitis, otitis media.
Typhoid fever (enteric fever) including multi-drug resistant typhoid fever.
Urinary tract infections including pyelonephritis, cystitis and cystourethritis.
Uncomplicated gonorrhea (cervical/urethral).
Cholecystitis, cholangitis.
Scarlet fever.
Sinusitis, tonsilitis, pharyngitis, otitis media.
Typhoid fever (enteric fever) including multi-drug resistant typhoid fever.
Dosage/Direction for Use
Cefixime may be given without to meals.
Usual Dose in Adults and Children (who can swallow capsule whole): See Table 2.
Usual Dose in Adults and Children (who can swallow capsule whole): See Table 2.
Usual Duration of Treatment: Most infections: 7 to 14 days.
Infections due to Streptococcus pyogenes: at least 10 days.
Recommended Dose for Specific Infections in Adults: See Table 3.
Infections due to Streptococcus pyogenes: at least 10 days.
Recommended Dose for Specific Infections in Adults: See Table 3.
Typhoid Fever in Children: Total daily dose: 15 to 20 mg/kg body weight given as a single dose or divided into two equal doses every 12 hours for 7 to 14 days.
Maximum dose: 400 mg/day.
Dosage in Adults with Renal Impairment: Adult patients whose creatinine clearance is between 20 and 40 mL/min should be given 75% of the standard dosage (i.e., 300 mg/day at the usual dosing interval). Patients whose creatinine clearance is less than 20 mL/min and those patients who are maintained on chronic ambulatory peritoneal dialysis or hemodialysis should be given 50% of the standard dosage (i.e., 200 mg/day at the usual dosing interval).
Or, as prescribed by a physician.
Maximum dose: 400 mg/day.
Dosage in Adults with Renal Impairment: Adult patients whose creatinine clearance is between 20 and 40 mL/min should be given 75% of the standard dosage (i.e., 300 mg/day at the usual dosing interval). Patients whose creatinine clearance is less than 20 mL/min and those patients who are maintained on chronic ambulatory peritoneal dialysis or hemodialysis should be given 50% of the standard dosage (i.e., 200 mg/day at the usual dosing interval).
Or, as prescribed by a physician.
Overdosage
Limited information is available on the acute toxicity of cefixime in humans. In healthy adults who received cefixime in single doses up to 2 g, adverse effects were similar to those seen with usual doses of the drug and included mild to moderate adverse GI effects.
There is no specific antidote for cefixime toxicity. In case of acute overdosage, gastric lavage may be indicated. Cefixime is not removed in significant quantities from the circulation by hemodialysis or peritoneal dialysis.
There is no specific antidote for cefixime toxicity. In case of acute overdosage, gastric lavage may be indicated. Cefixime is not removed in significant quantities from the circulation by hemodialysis or peritoneal dialysis.
Administration
May be taken with or without food.
Contraindications
Known hypersensitivity to cefixime or other cephalosporins, to penicillins or any component of the product.
Special Precautions
Hypersensitivity Reactions: Careful inquiry should be made prior to cefixime therapy to determine whether the patient has had previous hypersensitivity reactions to cephalosporins, penicillins or other drugs. Use with caution in penicillin-sensitive patients since cross-sensitivity among beta lactam antibiotics has been clearly documented and may occur in up to 10% of patients with a history of allergy to penicillin. In case of an allergic reaction to cefixime, the drug should be discontinued.
Serious acute hypersensitivity reactions may require treatment with epinephrine and other emergency measures including oxygen, intravenous (IV) fluids, IV antihistamines, corticosteroids, pressor amines, and airway management as clinically indicated.
Severe Cutaneous Adverse Reactions: Severe cutaneous adverse reactions including toxic epidermal necrolysis, Stevens-Johnson syndrome and drug rash with eosinophilia and systemic symptoms (DRESS) have been reported in some patients on cefixime. When severe cutaneous adverse reactions occur, cefixime should be discontinued and appropriate treatment and/or measures should be taken.
Clostridium difficile-associated diarrhea (CDAD): This has been reported with the use of nearly all antibacterial agents, including cefixime, and may range in severity from mild diarrhea to fatal colitis. It is important to consider this diagnosis in patients who present with diarrhea following administration of antibacterial agents.
Hemolytic Anemia: Cefixime should not be used in patients with a history of cephalosporin-associated hemolytic anemia since the recurrence of hemolysis is much more severe.
An immune-mediated hemolytic anemia has been observed in patients receiving cephalosporin antibiotics, including cefixime. Severe cases of hemolytic anemia, including fatalities, have been reported with cephalosporins in both adults and children. If a patient develops anemia anytime during, or within 2 to 3 weeks following the administration of cefixime, the diagnosis of a cephalosporin-associated anemia should be considered and the drug discontinued until the etiology is determined.
Periodic monitoring of signs and symptoms of hemolytic anemia, including measurement of hematological parameters or drug-induced antibody testing, where appropriate, is recommended.
Acute Renal Failure: As with other cephalosporins, cefixime may cause acute renal failure including tubulointerstitial nephritis. In case of renal failure, cefixime should be discontinued and appropriate therapy instituted.
Prothrombin Time: Cephalosporins may be associated with a fall in prothrombin activity. Patients who are at risk are those with kidney or liver impairment or poor nutritional states, as well as patients receiving a protracted course of antimicrobial therapy. Prothrombin time should be monitored in patients at risk and exogenous Vitamin K administered as indicated.
Seizures: These have been reported with several cephalosporins (e.g., cefuroxime, ceftazidime), particularly in patients with renal impairment in whom dosage of the drug was not reduced. If seizures occur during treatment with a cephalosporin, the drug should be discontinued and anticonvulsant therapy initiated as clinically indicated.
Other Precautions: As with other broad-spectrum antibiotics, cefixime should be given with caution in individuals with a history of colitis. The safety and efficacy of cefixime have not been established in patients with gastrointestinal malabsorption.
Prescribing cefixime in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of antibiotic resistance.
As with other antibacterial drugs, long term or repeated use may result in overgrowth of non-susceptible organisms, including fungi.
Renal impairment: Experience in children with renal impairment is very limited.
Use in Children: The safety and efficacy of cefixime in children less than six (6) months old have not been established. The incidence of GI adverse reactions such as diarrhea and loose stools, in children receiving cefixime suspension, was comparable to the incidence seen in adults receiving cefixime tablets.
Use in Elderly: Elderly patients are more likely to have decreased renal function, therefore, care should be taken in dose selection and renal function should be monitored.
Serious acute hypersensitivity reactions may require treatment with epinephrine and other emergency measures including oxygen, intravenous (IV) fluids, IV antihistamines, corticosteroids, pressor amines, and airway management as clinically indicated.
Severe Cutaneous Adverse Reactions: Severe cutaneous adverse reactions including toxic epidermal necrolysis, Stevens-Johnson syndrome and drug rash with eosinophilia and systemic symptoms (DRESS) have been reported in some patients on cefixime. When severe cutaneous adverse reactions occur, cefixime should be discontinued and appropriate treatment and/or measures should be taken.
Clostridium difficile-associated diarrhea (CDAD): This has been reported with the use of nearly all antibacterial agents, including cefixime, and may range in severity from mild diarrhea to fatal colitis. It is important to consider this diagnosis in patients who present with diarrhea following administration of antibacterial agents.
Hemolytic Anemia: Cefixime should not be used in patients with a history of cephalosporin-associated hemolytic anemia since the recurrence of hemolysis is much more severe.
An immune-mediated hemolytic anemia has been observed in patients receiving cephalosporin antibiotics, including cefixime. Severe cases of hemolytic anemia, including fatalities, have been reported with cephalosporins in both adults and children. If a patient develops anemia anytime during, or within 2 to 3 weeks following the administration of cefixime, the diagnosis of a cephalosporin-associated anemia should be considered and the drug discontinued until the etiology is determined.
Periodic monitoring of signs and symptoms of hemolytic anemia, including measurement of hematological parameters or drug-induced antibody testing, where appropriate, is recommended.
Acute Renal Failure: As with other cephalosporins, cefixime may cause acute renal failure including tubulointerstitial nephritis. In case of renal failure, cefixime should be discontinued and appropriate therapy instituted.
Prothrombin Time: Cephalosporins may be associated with a fall in prothrombin activity. Patients who are at risk are those with kidney or liver impairment or poor nutritional states, as well as patients receiving a protracted course of antimicrobial therapy. Prothrombin time should be monitored in patients at risk and exogenous Vitamin K administered as indicated.
Seizures: These have been reported with several cephalosporins (e.g., cefuroxime, ceftazidime), particularly in patients with renal impairment in whom dosage of the drug was not reduced. If seizures occur during treatment with a cephalosporin, the drug should be discontinued and anticonvulsant therapy initiated as clinically indicated.
Other Precautions: As with other broad-spectrum antibiotics, cefixime should be given with caution in individuals with a history of colitis. The safety and efficacy of cefixime have not been established in patients with gastrointestinal malabsorption.
Prescribing cefixime in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of antibiotic resistance.
As with other antibacterial drugs, long term or repeated use may result in overgrowth of non-susceptible organisms, including fungi.
Renal impairment: Experience in children with renal impairment is very limited.
Use in Children: The safety and efficacy of cefixime in children less than six (6) months old have not been established. The incidence of GI adverse reactions such as diarrhea and loose stools, in children receiving cefixime suspension, was comparable to the incidence seen in adults receiving cefixime tablets.
Use in Elderly: Elderly patients are more likely to have decreased renal function, therefore, care should be taken in dose selection and renal function should be monitored.
Use In Pregnancy & Lactation
Pregnancy: (Pregnancy Category B) Reproduction studies performed in mice and rats up to 400 times the human dose have not revealed evidence of harm to the fetus. There are no adequate and well-controlled studies in pregnant women, and the drug should be used during pregnancy only when clearly needed.
Lactation: It is not known whether cefixime is excreted in human milk. Consideration should be given to discontinuing breastfeeding temporarily during treatment with cefixime.
Lactation: It is not known whether cefixime is excreted in human milk. Consideration should be given to discontinuing breastfeeding temporarily during treatment with cefixime.
Adverse Reactions
Most adverse effects reported with cefixime were similar to those reported with other oral cephalosporins and were usually mild and transient in nature.
Gastrointestinal (GI): Abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, loose or frequent stools/stool changes, nausea, vomiting, pseudomembranous colitis, pruritus ani.
Dermatologic/Hypersensitivity Reactions: Anaphylactic/anaphylactoid reactions (including shock and fatalities), angiodema, arthralgia, drug fever, erythema multiforme, facial edema, pruritus, skin rashes, serum sickness-like reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), urticaria.
Hepatic: Transient elevation of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, bilirubin, and lactate dehydrogenase (LDH); hepatitis, jaundice (chloestatic and/or hepatocellular).
Renal/Genitounitary: Transient elevations in blood urea nitrogen (BUN) and serum creatinine levels; acute renal failure including tubulointerstitial nephritis; dysuria, pyuria, genital pruritus, vaginitis, vaginal candidiasis.
Nervous system: Dizziness, headache, fatigue, insomnia, malaise, nervousness, seizures, somnolence.
Hematologic: Transient thrombocytopenia, thrombocytosis, leukopenia, leukocytosis, neutropenia, agranulocytosis, eosinophilia, and hypereosinophilia; immune hemolytic anemia; prolonged prothrombin time, prolonged partial thromboplastin time, decreased hemoglobin concentration and hematocrit.
Abnormal Laboratory Test: Hyperbilirubinemia.
Other Adverse Effects: Increased serum amylase concentrations; dyspnea, respiratory distress.
In addition to the adverse reactions listed previously which have been observed in patients treated with cefixime, the following adverse reactions and altered laboratory tests have been reported for cephalosporin-class antibiotics: Allergic reactions, hypersensitivity reactions including chills, joint pain or inflammation, hypotension; renal dysfunction, toxic nephropathy, hepatic dysfunction including cholestasis; aplastic anemia, epistaxis or hemorrhage, thrombocytemia, granulocytosis, monocytosis, lymphocytopenia, basophilia, hypoprothrombinemia (with or without bleeding), menstrual irregularities, tenesmus, epigastric pain, glossitis, candidiasis (oral thrush), taste alteration, decreased salivation, heartburn, colitis, nightmares, vertigo, chest pain, pleural effusion, pulmonary infiltrate, cough, and rhinitis, increased or decreased serum glucose concentration; superinfection.
Abnormal Laboratory Tests: Positive Coombs' test, pancytopenia, transient increase in gamma-glutamyl transferase, decreased serum albumin and/or total protein.
Gastrointestinal (GI): Abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, loose or frequent stools/stool changes, nausea, vomiting, pseudomembranous colitis, pruritus ani.
Dermatologic/Hypersensitivity Reactions: Anaphylactic/anaphylactoid reactions (including shock and fatalities), angiodema, arthralgia, drug fever, erythema multiforme, facial edema, pruritus, skin rashes, serum sickness-like reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), urticaria.
Hepatic: Transient elevation of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, bilirubin, and lactate dehydrogenase (LDH); hepatitis, jaundice (chloestatic and/or hepatocellular).
Renal/Genitounitary: Transient elevations in blood urea nitrogen (BUN) and serum creatinine levels; acute renal failure including tubulointerstitial nephritis; dysuria, pyuria, genital pruritus, vaginitis, vaginal candidiasis.
Nervous system: Dizziness, headache, fatigue, insomnia, malaise, nervousness, seizures, somnolence.
Hematologic: Transient thrombocytopenia, thrombocytosis, leukopenia, leukocytosis, neutropenia, agranulocytosis, eosinophilia, and hypereosinophilia; immune hemolytic anemia; prolonged prothrombin time, prolonged partial thromboplastin time, decreased hemoglobin concentration and hematocrit.
Abnormal Laboratory Test: Hyperbilirubinemia.
Other Adverse Effects: Increased serum amylase concentrations; dyspnea, respiratory distress.
In addition to the adverse reactions listed previously which have been observed in patients treated with cefixime, the following adverse reactions and altered laboratory tests have been reported for cephalosporin-class antibiotics: Allergic reactions, hypersensitivity reactions including chills, joint pain or inflammation, hypotension; renal dysfunction, toxic nephropathy, hepatic dysfunction including cholestasis; aplastic anemia, epistaxis or hemorrhage, thrombocytemia, granulocytosis, monocytosis, lymphocytopenia, basophilia, hypoprothrombinemia (with or without bleeding), menstrual irregularities, tenesmus, epigastric pain, glossitis, candidiasis (oral thrush), taste alteration, decreased salivation, heartburn, colitis, nightmares, vertigo, chest pain, pleural effusion, pulmonary infiltrate, cough, and rhinitis, increased or decreased serum glucose concentration; superinfection.
Abnormal Laboratory Tests: Positive Coombs' test, pancytopenia, transient increase in gamma-glutamyl transferase, decreased serum albumin and/or total protein.
Drug Interactions
Carbamazepine: Elevated carbamazepine levels have been reported when administered concomitantly with cefixime. Drug monitoring when these drugs are given together is advised.
Chloramphenicol: In vitro and in vivo antagonism have been noted between cephalosporins and chloramphenicol against a variety of Gram-positive and Gram-negative bacteria; therefore, it is recommended that combined therapy with chloramphenicol and a cephalosporin be avoided, particularly when bactericidal activity is considered important.
Nifedipine: Concomitant administration of cefixime and nifedipine increases oral bioavailabilty of cefixime as a result of higher Cmax and AUC.
Probenecid: Concomitant administration of probenecid reportedly increases Cmax and AUC of cefixime and decreases renal clearance and volume of distribution of the drug.
Salicylates: Concomitant administration of 650 mg oral dose of aspirin and a 400 mg oral dose of cefixime in healthy adult men may result in a 20 to 25% decrease in Cmax and AUC of cefixime but did not affect protein binding, serum t1/2 or renal clearance. This effect may not be clinically important since serum concentrations of cefixime remained higher than the MIC values reported for most susceptible organisms. However, some clinicians state that this effect may be clinically important in certain infections.
Warfarin and other anticoagulants: Increased prothrombin time, with or without clinical bleeding, has been reported when cefixime is given concomitantly.
Interference with Laboratory Tests: Nitroprusside test: A false-positive reaction for ketones in the urine may occur with tests using nitroprusside but not with those using nitroferricyanide.
Coombs' test: A false-positive Coombs' test has been reported during treatment with other cephalosporin antibiotics; therefore, it should be recognized that a positive Coombs' test may be due to the drug, e.g., Coombs' testing of newborns whose mothers have received cephalosporin antibiotics before parturition or in hematologic studies or in transfusion cross-matching procedures when antiglobulin tests are performed.
Clinitest, Benedict's solution, Fehling's solution: A false-positive reaction for glucose in the urine using Clinitest, Benedict's solution, or Fehling's solution may result when done during therapy with cefixime. It is recommended that other tests based on enzymatic glucose oxidase reactions (e.g., Clinistix) be used.
Chloramphenicol: In vitro and in vivo antagonism have been noted between cephalosporins and chloramphenicol against a variety of Gram-positive and Gram-negative bacteria; therefore, it is recommended that combined therapy with chloramphenicol and a cephalosporin be avoided, particularly when bactericidal activity is considered important.
Nifedipine: Concomitant administration of cefixime and nifedipine increases oral bioavailabilty of cefixime as a result of higher Cmax and AUC.
Probenecid: Concomitant administration of probenecid reportedly increases Cmax and AUC of cefixime and decreases renal clearance and volume of distribution of the drug.
Salicylates: Concomitant administration of 650 mg oral dose of aspirin and a 400 mg oral dose of cefixime in healthy adult men may result in a 20 to 25% decrease in Cmax and AUC of cefixime but did not affect protein binding, serum t1/2 or renal clearance. This effect may not be clinically important since serum concentrations of cefixime remained higher than the MIC values reported for most susceptible organisms. However, some clinicians state that this effect may be clinically important in certain infections.
Warfarin and other anticoagulants: Increased prothrombin time, with or without clinical bleeding, has been reported when cefixime is given concomitantly.
Interference with Laboratory Tests: Nitroprusside test: A false-positive reaction for ketones in the urine may occur with tests using nitroprusside but not with those using nitroferricyanide.
Coombs' test: A false-positive Coombs' test has been reported during treatment with other cephalosporin antibiotics; therefore, it should be recognized that a positive Coombs' test may be due to the drug, e.g., Coombs' testing of newborns whose mothers have received cephalosporin antibiotics before parturition or in hematologic studies or in transfusion cross-matching procedures when antiglobulin tests are performed.
Clinitest, Benedict's solution, Fehling's solution: A false-positive reaction for glucose in the urine using Clinitest, Benedict's solution, or Fehling's solution may result when done during therapy with cefixime. It is recommended that other tests based on enzymatic glucose oxidase reactions (e.g., Clinistix) be used.
Storage
Store at temperatures not exceeding 30°C. Protect from light.
Action
Pharmacology: Pharmacodynamics: Cefixime is a third generation cephalosporin with antibacterial activity similar to penicillins, carbacephems and cephamycins.
Cefixime exerts its bactericidal activity by interfering with the synthesis of the bacterial cell wall. It binds to specific penicillin-binding proteins responsible for the synthesis of peptidoglycan, a heteropolymeric structure that gives the cell wall its mechanical stability. The final stage of peptidoglycan synthesis involves completion of the cross-linking of the terminal glycine residue of the pentaglycine bridge to the fourth residue of the pentapeptide. The transpeptidase that catalyzes this step is inhibited by cephalosporins. Thus, inhibition of the transpeptidase interrupts peptidoglycan synthesis, causing formation of defective cell walls and osmotically unstable spheroplasts and lysis of the bacteria.
Pharmacokinetics: About 30% to 50% of a single oral dose of cefixime is absorbed. Food decreases the rate but generally does not affect the extent of drug absorption. Peak serum concentrations (Cmax) after a single, oral 200 or 400 mg dose of cefixime are attained between 2 to 6 hours.
After oral administration, cefixime is distributed into bile, sputum, tonsils, maxillary sinus mucosa, middle ear discharge, blister fluid, and prostatic fluid. Sputum concentrations may be 2% to 10% of concurrent serum concentrations; in one study, a single 200 mg oral dose of cefixime resulted in sputum concentrations of 0.03 to 0.12 mcg/mL. It is not known whether cefixime is distributed into CSF after oral administration.
About 65% to 75% of cefixime is bound to serum proteins, principally albumin, and such binding is not concentration-dependent over the range of 0.5 to 30 mcg/mL. The fraction of free cefixime in plasma may be slightly greater in patients with renal impairment than in those with normal renal function.
Cefixime crosses the placenta and is distributed in low concentrations into amniotic fluid and cord serum; cord serum concentrations may be 15 to 50% concurrent maternal plasma concentrations. No data are available on secretion of cefixime into human milk.
The half-life of cefixime is about 3 to 4 hours and is not dose-dependent. It is excreted renally via glomerular filtration and to a lesser extent by tubular secretion. Metabolites of cefixime have not been isolated from human serum or urine. About 7% to 41% of a single oral dose of the drug is excreted unchanged in urine within 24 hours. The remainder of the dose (up to 60%) is eliminated by nonrenal mechanism. In animal studies, it was noted that up to 10% of a single oral dose of cefixime is excreted unchanged in bile.
Cefixime is not removed to a significant degree by either hemodialysis or peritoneal dialysis.
Microbiology: Antimicrobial Spectrum of Activity: Cefixime is active against the following organisms, both in vitro and in clinical infections: See Table 1.
Cefixime exerts its bactericidal activity by interfering with the synthesis of the bacterial cell wall. It binds to specific penicillin-binding proteins responsible for the synthesis of peptidoglycan, a heteropolymeric structure that gives the cell wall its mechanical stability. The final stage of peptidoglycan synthesis involves completion of the cross-linking of the terminal glycine residue of the pentaglycine bridge to the fourth residue of the pentapeptide. The transpeptidase that catalyzes this step is inhibited by cephalosporins. Thus, inhibition of the transpeptidase interrupts peptidoglycan synthesis, causing formation of defective cell walls and osmotically unstable spheroplasts and lysis of the bacteria.
Pharmacokinetics: About 30% to 50% of a single oral dose of cefixime is absorbed. Food decreases the rate but generally does not affect the extent of drug absorption. Peak serum concentrations (Cmax) after a single, oral 200 or 400 mg dose of cefixime are attained between 2 to 6 hours.
After oral administration, cefixime is distributed into bile, sputum, tonsils, maxillary sinus mucosa, middle ear discharge, blister fluid, and prostatic fluid. Sputum concentrations may be 2% to 10% of concurrent serum concentrations; in one study, a single 200 mg oral dose of cefixime resulted in sputum concentrations of 0.03 to 0.12 mcg/mL. It is not known whether cefixime is distributed into CSF after oral administration.
About 65% to 75% of cefixime is bound to serum proteins, principally albumin, and such binding is not concentration-dependent over the range of 0.5 to 30 mcg/mL. The fraction of free cefixime in plasma may be slightly greater in patients with renal impairment than in those with normal renal function.
Cefixime crosses the placenta and is distributed in low concentrations into amniotic fluid and cord serum; cord serum concentrations may be 15 to 50% concurrent maternal plasma concentrations. No data are available on secretion of cefixime into human milk.
The half-life of cefixime is about 3 to 4 hours and is not dose-dependent. It is excreted renally via glomerular filtration and to a lesser extent by tubular secretion. Metabolites of cefixime have not been isolated from human serum or urine. About 7% to 41% of a single oral dose of the drug is excreted unchanged in urine within 24 hours. The remainder of the dose (up to 60%) is eliminated by nonrenal mechanism. In animal studies, it was noted that up to 10% of a single oral dose of cefixime is excreted unchanged in bile.
Cefixime is not removed to a significant degree by either hemodialysis or peritoneal dialysis.
Microbiology: Antimicrobial Spectrum of Activity: Cefixime is active against the following organisms, both in vitro and in clinical infections: See Table 1.
Cefixime has been shown to be active in vitro against most strains of Gram-positive organisms such as Streptococcus agalactiae and most strains of Gram-negative organisms such as Haemophilus parainfluenzae (β-lactamase positive and negative strains), Neisseria meningitidis, Proteus vulgaris, Klebsiella pneumoniae, Klebsiella oxytoca, Pasteurella multicoda, Providencia spp., Bordetella pertussis, Citrobacter freundii, Citrobacter amalonaticus, Citrobacter diversus, Helicobacter pylori, and Serratia marcescens; however, clinical efficacy has not been established.
Pseudomonas spp., strains of group D streptococci (including enterococci), Listeria monocytogenes, most strains of staphylococci (including methicillin-resistant strains) and most strains of Enterobacter are resistant to cefixime. In addition, most strains of Bacteroides fragilis and Clostridia are resistant to cefixime.
It is suggested to carry out susceptibility tests.
Pseudomonas spp., strains of group D streptococci (including enterococci), Listeria monocytogenes, most strains of staphylococci (including methicillin-resistant strains) and most strains of Enterobacter are resistant to cefixime. In addition, most strains of Bacteroides fragilis and Clostridia are resistant to cefixime.
It is suggested to carry out susceptibility tests.
MedsGo Class
Cephalosporins
Features
Brand
RiteMed
Full Details
Dosage Strength
200mg
Drug Ingredients
- Cefixime
Drug Packaging
Capsule 1's
Generic Name
Cefixime
Dosage Form
Capsule
Registration Number
DRP-5191
Drug Classification
Prescription Drug (RX)