Adult: 200-400 mg as a single or in 2 divided doses daily, according to the severity of infection. Treatment duration: 7-14 days, depending on the type and severity of infection. Child: 6 months to 10 years weighing <50 kg: As susp or chewable tab: 8 mg/kg daily as a single or in 2 divided doses; >10 years weighing >50 kg: Same as adult dose.
May be taken with or without food. May be taken w/ food or milk to reduce GI discomfort.
Reconstitution
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.
Contraindications
Hypersensitivity to cephalosporins.
Special Precautions
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.
Adverse Reactions
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).
Monitor renal and hepatic functions periodically. Observe for signs and symptoms of anaphylaxis during 1st dose.
Overdosage
Symptoms: Encephalopathy including convulsion, confusion, impaired consciousness and movement disorders. Management: General supportive treatment.
Drug Interactions
May enhance the effects of anticoagulants (e.g. warfarin) resulting in prolonged prothrombin time. May increase carbamazepine levels.
Lab Interference
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.
Action
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%).
Chemical Structure
Cefixime 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.
Storage
Store between 20-25°C. Reconstituted powder for oral susp: Store between 2-8°C, stable for up to 14 days.
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