Brand and Generic Names

Cefixime is known under its generic name, Cefixime. It is also marketed under different brand names depending on the region and manufacturer. Common brand names include Suprax and various generics may be available, often listed as Cefixime Tablets or Cefixime Capsules, followed by the strength of the dosage.

Drug Classification

Cefixime belongs to the class of antibiotics known as cephalosporins. It is a third-generation cephalosporin antibacterial and is classified as a beta-lactam antimicrobial. The mechanism of action involves inhibiting bacterial cell wall synthesis, leading to cell lysis and death. It is effective against a range of gram-positive and gram-negative bacteria.

Pharmacokinetics

After oral administration, Cefixime has an approximate bioavailability of 40-50%. It is stable in the presence of gastric acid, which allows for effective absorption via the gastrointestinal tract. The peak plasma concentrations are usually achieved within 2-6 hours of ingestion. Cefixime is bound to plasma proteins at a rate of about 65%. It is minimally metabolized in the liver and primarily excreted unchanged in the urine. The elimination half-life is approximately 3-4 hours in healthy individuals.

Indications for Use

Cefixime is indicated for the treatment of various infections caused by susceptible strains of designated microorganisms. These infections include uncomplicated urinary tract infections, otitis media, pharyngitis and tonsillitis, acute bronchitis, and uncomplicated gonorrhea. It may also be used in certain cases of community-acquired pneumonia when prescribed by a healthcare provider.

Dosage and Administration

The usual adult dosage for Cefixime varies depending on the type and severity of the infection being treated. For uncomplicated urinary tract infections or pharyngitis, a typical dosage might be 400 mg daily, which can be administered as a single dose or divided into two doses. Pediatric dosing is weight-based, generally around 8 mg/kg/day. Dosage adjustments may be necessary for patients with renal impairment.

Formulation Types

Cefixime is available in various formulations including tablets, capsules, chewable tablets, and oral suspensions. Tablet strengths commonly include 200 mg and 400 mg. The chewable tablets and oral suspensions are primarily used in pediatric patients or those who have difficulty swallowing pills. Proper reconstitution of oral suspension forms is necessary before use.

Potential Drug Interactions

Cefixime might interact with certain other medications. Concomitant use with warfarin can increase the risk of bleeding due to enhanced anticoagulant effects. It can reduce the efficacy of oral contraceptives, so additional contraceptive methods may be advised. Probenecid may increase the plasma concentration of Cefixime by inhibiting tubular secretion.

Mechanism of Action

The antibacterial action of Cefixime results from its ability to bind to penicillin-binding proteins located in the bacterial cell wall. This inhibits the final transpeptidation step of peptidoglycan synthesis, which is vital for maintaining cell wall integrity in bacteria. Consequently, it weakens and disrupts the bacterial cell wall, leading to cell lysis and death of the bacterium.

Contraindications

Hypersensitivity to Cefixime, any component of the formulation, or other cephalosporin antibiotics is a contraindication. Cross-sensitivity among beta-lactam antibiotics such as penicillins may occur. Patients with a history of severe allergic reactions or anaphylaxis to penicillins should be cautious, as there can be a cross-reactivity risk.

Adverse Effects

Cefixime may cause various side effects, though not everyone will experience them. The most common adverse effects include gastrointestinal disturbances, such as diarrhea, abdominal pain, nausea, and flatulence. Less commonly, dizziness, insomnia, and headaches may occur. Serious side effects, though rare, include severe hypersensitivity reactions and pseudomembranous colitis.

Storage and Stability

The storage of Cefixime depends on the form of the medication. Tablets and capsules should be stored at room temperature, away from moisture and light. The oral suspension should be stored in a refrigerator and used within the advised period after reconstitution, typically around 14 days. Shake oral suspension well before each use.

Special Population Considerations

Careful consideration is necessary when prescribing Cefixime to certain populations, including pediatric, elderly, pregnant, and lactating patients. In pediatric patients, dosage must be carefully calculated based on weight. While generally safe in the elderly, renal function should be monitored due to decreased renal clearance. Cefixime should only be used during pregnancy if clearly needed and should be approached with caution during lactation.

Impact on Diagnostic Tests

Cefixime may cause false-positive results for glucose in the urine using certain tests (Benedict’s solution, Fehling’s solution, or with copper sulfate test tablets). It can also interfere with the direct Coombs test, leading to false-positive results. Patients should inform laboratory personnel and healthcare providers about Cefixime treatment when undergoing these tests.