Cefixime: Difference between revisions

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==General==
==General==
*Type:  
*Type: [[Is Generation::3rd generation]] [[Is DrugClass::cephalosporin]]
*Dosage Forms:
*Dosage Forms: tablet, chewable tablet, oral suspension
*Common Trade Names:  
*Dosage Strengths: tablet: 400mg; chewable tablet: 100, 200mg; oral suspension: 100mg/5mL, 200mg/5mL, 500mg/mL
*Routes of Administration: PO
*Common Trade Names: Suprax


==Adult Dosing==
==Adult Dosing==
===Indications by Disease===
{{#ask: [[Has DrugName::Cefixime]] [[Has Population::Adult]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
===Indications by Disease===
{{#ask: [[Has DrugName::Cefixime]] [[Has Population::Pediatric]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Special Populations==
==Special Populations==
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*Renal Dosing
*Renal Dosing
**Adult
**Adult
*** CrCl ≥ 60 mL/min: No adjustment
*** CrCl 21 to 59 mL/min:
**** Chewable tablet: not recommended
**** Suspension: 260 mg once daily
*** CrCl ≤ 20
**** Chewable tablet: 200 mg once daily
**** 100 mg/5 mL suspension: 172 mg once daily
**** 200 mg/5 mL suspension: 176 mg once daily
**** 500 mg/5 mL suspension: 180 mg once daily
*** Hemodialysis
**** Chewable tablet: not recommended
**** Suspension: 260 mg once daily 
**Pediatric
**Pediatric
*** limited data
*** Mild to moderate impairment - no adjustment
*** Severe impairment and anuric - reduce dose 50%
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult
*** Not defined
**Pediatric
**Pediatric
*** Not defined


==Contraindications==
==Contraindications==
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==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 3-4 hr
*Metabolism:  
*Metabolism:  
*Excretion:  
*Excretion: Urine (50% as unchanged drug), feces (10%)
*Mechanism of Action:
*Mechanism of Action: arrests bacterial cell wall synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||X1
|-
| ||[[MSSA]]||R
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||R
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||I
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||I
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||'''S'''
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||'''S'''
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||R
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>


<references/>
[[Category:Pharmacology]] [[Category:ID]]
[[Category:Drugs]]
 
Cefixime: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

Latest revision as of 20:38, 20 March 2026

General

  • Type: 3rd generation cephalosporin
  • Dosage Forms: tablet, chewable tablet, oral suspension
  • Dosage Strengths: tablet: 400mg; chewable tablet: 100, 200mg; oral suspension: 100mg/5mL, 200mg/5mL, 500mg/mL
  • Routes of Administration: PO
  • Common Trade Names: Suprax

Adult Dosing

Indications by Disease

DiseaseDoseContext
Cervicitis800 mg PO x 1GC/Chlamydia, CTX Contraindicated
Pyelonephritis400mg PO daily x 10 daysOutpatient
Typhoid fever10-15 mg/kg IV q 12 hrs x 8 daysQuinolone Resistant, Parenteral
Urethritis in men800 mg PO x 1CTX Contraindicated

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Acute cystitis8mg/kg/day PO daily (max 400mg)Pediatric
Pyelonephritis8mg/kg PO daily x 10-14 days (max 400mg)Pediatric Outpatient
Typhoid fever15-20mg/kg/day PO divided BID x 7-14 days (max 400mg/dose)Pediatric Oral Step-down

Special Populations

  • Pregnancy:
  • Lactation:
  • Renal Dosing
    • Adult
      • CrCl ≥ 60 mL/min: No adjustment
      • CrCl 21 to 59 mL/min:
        • Chewable tablet: not recommended
        • Suspension: 260 mg once daily
      • CrCl ≤ 20
        • Chewable tablet: 200 mg once daily
        • 100 mg/5 mL suspension: 172 mg once daily
        • 200 mg/5 mL suspension: 176 mg once daily
        • 500 mg/5 mL suspension: 180 mg once daily
      • Hemodialysis
        • Chewable tablet: not recommended
        • Suspension: 260 mg once daily
    • Pediatric
      • limited data
      • Mild to moderate impairment - no adjustment
      • Severe impairment and anuric - reduce dose 50%
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 3-4 hr
  • Metabolism:
  • Excretion: Urine (50% as unchanged drug), feces (10%)
  • Mechanism of Action: arrests bacterial cell wall synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA R
MRSA R
CA-MRSA R
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae S
N. meningitidis I
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp I
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus X1
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica S
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi S
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) R
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014

Cefixime: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

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