Cefixime
Mechanism :
Cefixime is a semisynthetic third generation cephalosporin antibiotic intended for oral administration. Cephalosporins are bactericidal because of their inhibition of cell-wall synthesis.
Indication :
- Gram negative infections
- Urinary tract infections
- Diarrhea
- Enteric fever
Contraindications :
Cefixime is contraindicated in patients with known allergy to the cephalosporin group of antibiotics.
Dosing :
Children:
Oral 8 mg/kg/24 hours in 1-2 divided doses;
In typhoid:
20 mg/kg/day in 2 divided doses for 14 days.
Adolescent:
Oral 400 mg/24 hours in 1-2 divided doses.
Adverse Effect :
Pseudomembranous colitis, nausea and vomiting, diarrhea, hypersensitivity (rash, urticaria, angioedema, pruritus), hepatic dysfunction including cholestasis and elevations in serum transaminase, moderate transient neutropenia, fever, thrombocytopenia, erythema multiforme, Stevens-Johnson syndrome, serum sickness, and arthralgia.
Interaction :
False positive glycosuria reaction.
Cephalosporin: Positive direct Coombs tests have been reported during treatment with the cephalosporin antibiotics.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | 200 mg/day |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Dialysed. Dose as in GFR=10– 20 mL/min |
Hepatic Dose :
No dosage adjustments are recommended.