Cefixime is an antibiotic useful to treat a number of bacterial infections. This includes otitis media, strep throat, pneumonia, urinary tract infections, gonorrhea, and Lyme disease. For gonorrhea typically only one dose is required. In the United States it is a second line treatment to ceftriaxone for gonorrhea. It is taken by mouth

Molecular Structure


Class of Drug

Cephalosporin, Third generation.

Mechanism of Action

Binds to penicillin-binding proteins and disrupts or inhibits bacterial cell wall synthesis.

Susceptible organisms in vivo: Highly effective against betahemolytic streptococci, penicillin-susceptible Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis. Neisseria gonorrhoeae, and many Enterobacteriaceae. Poor activity against Staphylococcus aureus.

Indications / Dosage / Route

Routes of Administration: Oral only.

Condition: Uncomplicated UTIs, otitis media, pharyngitis, tonsillitis, acute bronchitis, acute exacerbations of or chronic bronchitis

Dose: Adults: 400 mg once daily or 200 mg ql2h.

Children: 8 mg/kg/d or 4 mg/kg ql2h.

Condition: Uncomplicated gonorrhea

Dose: Adults: 400 mg/d.

Adjustment of Dosage

Kidney disease: ccreatinine clearance <60 mL/min: standard dosage; creatinine clearance 21-60 mL/min: 75% of standard dosage; creatinine clearance >20 mL/min: 50% of standard dosage.

Liver disease: None.

Elderly: None

Pediatric: See above.

Food and Drug Interactions

Food: Take with yogurt or buttermilk (4 oz/d) to maintain bacterial flora and reduce the possibility of severe GI effects.

Pregnancy: Category B.

Lactation: No data available. American Academy of Pediatrics considers cephalosporins compatible with breastfeeding.

Contraindications: Hypersensitivity to other cephalosporins or related antibiotics, eg, penicillin.

Warnings / Precautions

> Use with caution in patients with the following condition: kidney disease.

> It is recommended to continue therapy for at least 2-3 days after symptoms are no longer present. For group A beta-hemolytic streptococcal infections, therapy should be continued for 10 days.

> Before use, determine if patient had previous hypersensitivity reaction to cephalosporins or penicillins. Incidence of cross-sensitivity to penicillins is 1-16%. A negative response to penicillin does not preclude allergic reaction to a cephalosporin.

Clinically Important Drug Interactions

> Cefixime increases effects/ toxicity of carbamazepine.

Adverse Reactions

> Common: Diarrhea, other GI symptoms.

> Serious: pseudomembranous colitis, hypersensitivity reactions, hepatitis, nephrotoxicity, bone marrow suppression, increased PT, seizures.

Parameters to Monitor

> CBC with differential and platelets, PT, serum BUN and creatinine, liver enzymes.

> Temperature for signs of drug-induced persistent fever.

> Signs and symptoms of antibiotic-induced bacterial or fungal superinfection.

> Signs and symptoms of renal toxicity.

> Signs and symptoms of fluid retention, particularly in patients receiving sodium salts of cephalosporins.

Advice to Patient

> Allow at least 1 hour between taking this medication and a bacteriostatic antibiotic, eg, tetracycline or amphenicol.

Further Useful Info

> Uses of cefixime include single-dose therapy of gonorrhea, upper and lower respiratory infections, UTIs, respiratory infections, COPD exacerbators.

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