cefixime


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cefixime

 [sĕ-fik´sēm]
a third-generation cephalosporin antibiotic effective against a wide range of bacteria, used in the treatment of otitis media, bronchitis, pharyngitis, tonsillitis, gonorrhea, and urinary tract infections; administered orally.

cefixime

Suprax

Pharmacologic class: Third-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity.

Availability

Oral suspension: 100 mg/5 ml

Tablets: 400 mg

Indications and dosages

Uncomplicated gonorrhea caused by Neisseria gonorrhoeae
Adults and children weighing more than 50 kg (110 lb): 400 mg P.O. daily

Uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis; otitis media caused by Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes; pharyngitis and tonsillitis caused by S. pyogenes; acute bronchitis and acute exacerbation of chronic bronchitis caused by H. influenzae and Streptococcus pneumoniae
Adults and children older than age 12 or weighing more than 50 kg (110 lb): 400 mg P.O. daily or 200 mg P.O. q 12 hours
Children ages 12 and younger or weighing 50 kg (110 lb) or less: 8 mg/kg P.O. daily or 4 mg/kg P.O. q 12 hours

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Obtain specimens for culture and sensitivity testing as necessary before starting therapy.
• Know that drug may be taken with food.
• Be aware that suspension should be given for otitis media because it provides higher serum concentration.

Adverse reactions

CNS: headache, lethargy, paresthesia, syncope, seizures

CV: hypotension, palpitations, chest pain, vasodilation

EENT: hearing loss

GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression

Hepatic: hepatic failure, hepatomegaly

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: urticaria, maculopapular or erythematous rash

Other: chills, fever, superinfection, anaphylaxis, serum sickness

Interactions

Drug-drug.Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Probenecid: decreased excretion and increased blood level of cefixime

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels
Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results

Hemoglobin, platelets, white blood cells: decreased values

Drug-herbs.Angelica, anise, arnica, asafetida, bogbean, boldo, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, horse chestnut, horseradish, licorice, meadowsweet, onion, papain, passionflower, poplar, prickly ash, quassia, red clover, turmeric, wild carrot, wild lettuce, willow: increased risk of bleeding

Patient monitoring

• Monitor baseline CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.
• Be aware that cross-sensitivity to penicillins may occur.

Patient teaching

• Tell patient to take once-daily doses at same time each day.
• Advise patient to take drug exactly as prescribed and to continue to take full amount prescribed even when he feels better.
• Instruct patient to report signs and symptoms of allergic response and other adverse reactions, such as rash, easy bruising, bleeding, severe GI problems, or difficulty breathing.
• Caution patient not to take herbs without consulting prescriber.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

cefixime

/ce·fix·ime/ (sĕ-fik´sēm) a third-generation cephalosporin effective against a wide range of bacteria, used in the treatment of otitis media, bronchitis, pharyngitis, tonsillitis, gonorrhea, and urinary tract infections.

cefixime

A CEPHALOSPORIN ANTIBIOTIC drug. A brand name is Suprax.

cefixime (sef´iksēm´),

n brand name: Suprax;
drug class: third-generation cephalosporin;
action: inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable;
uses: uncomplicated urinary tract infections, pharyngitis and tonsillitis, otitis media, acute bronchitis, and acute exacerbations of chronic bronchitis.

cefixime

a third generation cephalosporin antibiotic.
References in periodicals archive ?
The approval of our Cefixime for oral suspension 200mg/5ml product allows us to increase our share of the cephalosporin oral suspension pediatric market.
It consisted of either a single 400-mg dose of cefixime and a 1-g sachet of azithromycin for partners of patients with gonorrhea or azithromycin only for partners of patients with chlamydia.
Cefixime 200mg, Tab-paracetamol 650mg, Tab-aceclofenac 100mg, Tab-diclofenac 50mg, Tab-aspirin 75mg Tab-aspirin 150mg, Tab-clopidogrel 75mg, Tab-chymotrypsin Tab-atorvastatin 20mg etc.
By 2007, the Centers for Disease Control and Prevention (CDC) no longer recommended ciprofloxacin or other fluoroquinolones for treatment of gonorrhea, which make the cephalosporins cefixime or ceftriaxone the only remaining recommended treatment option (9).
For subjects with gonorrhea, a single 400-mg dose of cefixime and 1-g sachet of azithromycin were given.
All took a single, 2-g dose of metronidazole, for BV, plus a 1-g dose of azithromycin and a 400-mg dose of cefixime, for empiric treatment of cervicitis.
gonorrhoeae has emerged, and cefixime has now been withdrawn from use in Japan.
Resistance to ciprofloxacin and other fluoroquinolones limits treatment options because of the current absence of cefixime from the market.
Before admission, the patient was treated with cefixime (400 mg/d for 3 days) and cefradine (2 g/d for 2 days) without abatement of the fever.
Cefixime (Suprax) and cefdinir (Omnicef) were each used in two studies, and cefadroxil (Duricef), cefotiam, and cefprozil (Cefzil) were each used in a single study.
Earlier, Lupin had licensed the Suprax(R) trademark on an exclusive basis for the United States to launch Cefixime Dry Suspension and Cefixime Tablet, recently approved by the USFDA.