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Cefixime
Cefixime is a third-generation cephalosporin antibiotic used to treat a variety of bacterial infections. It is particularly effective against gram-negative bacteria but also works against some gram-positive bacteria. Cefixime is commonly prescribed for conditions such as urinary tract infections (UTIs), otitis media (middle ear infections), pharyngitis, tonsillitis, bronchitis, pneumonia, and gonorrhea. Like other antibiotics, it works by stopping the growth of bacteria.
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Frequently Asked Questions
How long does it take for cefixime to work?
Cefixime typically starts to relieve symptoms within a few days of starting treatment. However, it is important to complete the full course of the antibiotic to ensure the infection is fully treated.
Can I take cefixime if I’m allergic to penicillin?
Some people who are allergic to penicillin may also be allergic to cephalosporins like cefixime. It’s important to inform your healthcare provider about any penicillin allergies before taking cefixime.
What should I do if I miss a dose of cefixime?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and take the next dose at the regular time. Do not double the dose to make up for the missed one.
Can cefixime treat viral infections like the flu?
No, cefixime is an antibiotic and only works against bacterial infections. It is not effective against viral infections like the flu or common cold.
Can cefixime cause diarrhea?
Yes, diarrhea is a common side effect of cefixime. However, severe or persistent diarrhea may be a sign of a serious condition called Clostridium difficile-associated diarrhea (CDAD), which requires medical attention.
Is cefixime safe for children?
Yes, cefixime is commonly prescribed to children for bacterial infections, although the dose is adjusted based on the child's weight and age. Always follow the healthcare provider’s instructions for dosing in children.
What should I do if I experience severe diarrhea while taking cefixime?
If you experience persistent or severe diarrhea, contact your healthcare provider. This may be a sign of Clostridium difficile-associated diarrhea (CDAD), which requires medical attention.
Comprehensive Drug Guide
How Does Cefixime Work?
Cefixime works by binding to penicillin-binding proteins (PBPs) located inside bacterial cell walls. This inhibits the final stage of bacterial cell wall synthesis, leading to cell lysis and death. Cefixime is bactericidal, meaning it kills bacteria directly rather than just stopping their growth.
Common Dosages
- Adults:
- 400 mg once daily or 200 mg twice daily, depending on the infection.
- Children:
- 8 mg/kg of body weight per day, administered as a single dose or divided into two doses.
The exact dose depends on the severity of the infection and the patient’s age and weight.
Typical Dosing
- Administration: Cefixime can be taken with or without food. The oral suspension should be shaken well before use, and the dose should be measured using a specialized spoon or dosing syringe.
- Frequency: Cefixime is typically taken once or twice daily.
- Duration of Use: The duration of treatment depends on the type of infection but generally lasts for 7 to 14 days.
Typical Dosing
FDA Approved Indications
- Uncomplicated Urinary Tract Infections (UTIs): Caused by E. coli or Proteus mirabilis.
- Otitis Media (Middle Ear Infections): Caused by bacteria such as Haemophilus influenzae and Streptococcus pneumoniae.
- Pharyngitis and Tonsillitis: Caused by Streptococcus pyogenes.
- Uncomplicated Gonorrhea: For the treatment of gonorrhea caused by Neisseria gonorrhoeae.
- Bronchitis: Used to treat acute exacerbations of chronic bronchitis.
- Pneumonia: Treats mild to moderate bacterial pneumonia.
Who Shouldn't Take Cefixime?
- Hypersensitivity to cefixime or other cephalosporins.
- Previous severe allergic reactions to penicillins, as cross-reactivity can occur between penicillins and cephalosporins in some patients.
Advice From The Pharmacist
- Complete the full prescribed course, even if symptoms improve before finishing the medication, to prevent antibiotic resistance.
- Take doses at evenly spaced intervals to maintain effective levels in the bloodstream.
- Use a proper measuring device for liquid forms (oral suspension) to ensure an accurate dose.
- Inform their doctor if they have a history of allergic reactions to antibiotics, particularly penicillins or cephalosporins.
- Report any severe or persistent diarrhea to their healthcare provider, as this could be a sign of Clostridium difficile-associated diarrhea (CDAD).
Side Effects of Cefixime
Common Side Effects
- Diarrhea
- Nausea or vomiting
- Stomach pain or cramps
- Headache
- Dizziness
- Rash or itching
Uncommon/Severe Side Effects
- Severe Allergic Reactions (Anaphylaxis): Symptoms include hives, swelling, difficulty breathing, and severe rash.
- Clostridium difficile-Associated Diarrhea (CDAD): Prolonged antibiotic use can disrupt the normal gut flora, allowing harmful bacteria like C. difficile to grow and cause severe diarrhea.
- Kidney Issues: Cefixime can cause kidney damage in rare cases, especially in patients with pre-existing kidney disease.
- Blood Disorders: Such as thrombocytopenia (low platelet count) or neutropenia (low white blood cell count).
Risks and Warnings of Cefixime
- Allergic Reactions: Patients with a history of cephalosporin or penicillin allergies should use cefixime with caution, as cross-reactivity can occur.
- Clostridium difficile Infection: Prolonged use of antibiotics like cefixime can lead to overgrowth of C. difficile in the gut, causing severe diarrhea. Patients should report any persistent diarrhea to their healthcare provider.
- Kidney Function: Cefixime is eliminated by the kidneys, so patients with impaired kidney function may need dosage adjustments.
Interactions with Cefixime
Common Drug Interactions
- Probenecid: This medication increases the level of cefixime in the blood by reducing its excretion through the kidneys, potentially increasing the risk of side effects.
- Warfarin: Cefixime may enhance the anticoagulant effect of warfarin, increasing the risk of bleeding.
- Live Bacterial Vaccines: Antibiotics like cefixime can reduce the effectiveness of certain live vaccines (e.g., the typhoid vaccine).
Alternatives to Cefixime
- Other Cephalosporins: Such as cefuroxime or cephalexin, which have similar bacterial coverage.
- Penicillins: Such as amoxicillin, for patients who do not have penicillin allergies.
- Macrolides: Such as azithromycin or clarithromycin, which are often used for patients allergic to cephalosporins or penicillins.
- Fluoroquinolones: Such as ciprofloxacin or levofloxacin, used for certain types of bacterial infections.
