cefixime

Action and Spectrum

Actions and spectrum:

cefixime is a third-generation cephalosporin antibiotic that is used to treat a variety of bacterial infections, including respiratory tract infections, urinary tract infections, and sexually transmitted infections.

The mechanism of action of cefixime involves inhibition of bacterial cell wall synthesis. cefixime interferes with the formation of peptidoglycan, a complex molecule that provides structural integrity to the bacterial cell wall. By inhibiting the formation of peptidoglycan, cefixime disrupts the normal structure of the cell wall and leads to bacterial cell death.

Spectrum

The spectrum of cefixime refers to the range of bacteria that it is effective against. Cefixime is a broad-spectrum antibiotic that is used to treat a variety of bacterial infections.

cefixime has activity against both gram-negative and gram-positive bacteria. It is particularly effective against gram-negative bacteria, such as Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Proteus mirabilis, and Neisseria gonorrhoeae. It is also active against some gram-positive bacteria, such as Streptococcus pneumoniae.

Drug Interaction

Adverse Reaction

Frequency defined:

>10%

Diarrhea (16%)

Frequency not defined:

Abdominal pain

Elevated transaminases

Increased creatinine

Prolonged prothrombin time (PT)

Serum sickness-like reaction

Thrombocytopenia

Vaginitis

Candidiasis

Dyspepsia

Erythema multiforme

Flatulence

Leukopenia

Pruritus

Rash

Thrombocytopenia

Stevens-Johnson syndrome

Vomiting

Black Box Warning

Contraindication / Caution

Contraindications/caution:

Contraindication

• Allergic reactions: Patients who have had a previous allergic reaction to cefixime or other cephalosporin antibiotics should not take cefixime.
• Severe kidney disease: Cefixime is eliminated from the body by the kidneys, and there is increased risk for patients with severe kidney disease side effects from the drug.
• Pregnancy and breast-feeding: Cefixime have not been well-studied in pregnant women, and it is not known if the drug is safe for use during pregnancy. Drug interactions: cefixime can interact with other medications, including anticoagulants, probenecid, and some oral contraceptives.
  caution
• Antibiotic-associated diarrhea: cefixime, like all antibiotics, can break down the normal balance of bacteria in the stomach and lead to the overgrowth of Clostridium difficile, a bacterium that can cause severe diarrhea.
•  Superinfection: The use of antibiotics, including cefixime, can promote the growth of antibiotic-resistant bacteria.

Pregnancy / Lactation

Pregnancy consideration: USFDA pregnancy category A

Lactation: safety and efficacy not established

Pregnancy category:

Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.

Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women.

Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women

Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women.

Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology:

The mechanism of action of cefixime involves binding the drug to specific penicillin-binding proteins (PBPs) in the bacterial cell wall. PBPs are enzymes involved in the synthesis and maintenance of the cell wall, and by binding to these proteins, cefixime interferes with the normal functioning of the cell wall. This weakens the cell wall, making it more susceptible to damage and eventually causing the bacterial cell to lyse or break apart.

Pharmacodynamics

cefixime acts by binding to penicillin-binding proteins (PBPs) located on the bacterial cell wall, thereby preventing the formation of cross-links between the peptidoglycan chains. This leads to a destabilization of the bacterial cell wall, resulting in its lysis and death of the bacterium.

Pharmacokinetics

Absorption

cefixime is rapidly absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are achieved approximately 2-3 hours after dosing. The bioavailability of cefixime is approximately 50-70%, which means that a significant portion of the drug is absorbed by the body.

Distribution
cefixime is widely distributed in the body and has good penetration into many tissues and body fluids, including the respiratory tract, urinary tract, and bone. The drug is also able to cross the blood-brain barrier, making it effective for the treatment of central nervous system infections.

Metabolism

cefixime is not metabolized in the body and is excreted unchanged in the urine.

Excretion:

cefixime is mainly excreted unchanged in the urine, with approximately 70-80% of an oral dose being excreted in the urine within 24 hours. The remaining drug is excreted in the feces.The half-life of cefixime is approximately 2-3 hours, meaning that the drug is rapidly eliminated from the body.

Adminstartion

Administration:

• Dosage: The recommended adult dose of cefixime for treating various bacterial infections is 400 mg once daily or 200 mg twice daily. Children weighing more than 50 kg can usually be treated with the adult dose, while children weighing less than 50 kg may require a lower dose.
• Frequency of Administration: Cefixime is usually administered every 12 hours.
• Route of Administration: Cefixime is usually taken orally as a tablet or capsule. It can also be administered intravenously in certain cases, such as in patients with severe infections who cannot take oral medications.
• Timing of Administration: Cefixime should be taken at the same time every day to maintain therapeutic levels of the drug in the body.
• With or Without Food: Cefixime can be taken with or without food. However, taking the drug with food may reduce the risk of gastrointestinal side effects, such as nausea and vomiting.
• Missed Doses: it should be taken as soon as possible in case of a missed dose.
• Duration of Treatment: The duration of treatment with cefixime varies depending on the type of infection being treated and the patient’s response to the drug. In general, treatment is continued for 7-10 days or until the patient is symptom-free.

Patient Information Leaflet

Patient information leaflet

Generic Name: cefixime

Pronounced: (sef-IX-eem)

Why do we use cefixime?

cefixime is a third-generation cephalosporin antibiotic that is used to treat a variety of bacterial infections.

• Respiratory tract infections: cefixime treats respiratory tract infections, such as pharyngitis, tonsillitis, bronchitis, and pneumonia.
• Urinary tract infections: cefixime treats UTIs, including cystitis, urethritis, and pyelonephritis.h
• Gastrointestinal infections: cefixime treats gastrointestinal infections, such as enteritis and gastroenteritis.
• Sexually transmitted infections: cefixime treats sexually transmitted infections, such as gonorrhea.
• Otitis media: cefixime is used to treat otitis media, a middle ear infection.
• Skin and soft tissue infections: cefixime helps in treating infections, such as cellulitis and impetigo.
• Septicemia: cefixime is used to treat septicemia, a severe bacterial infection that affects the bloodstream.