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

a third generation cephalosporin antibiotic.
References in periodicals archive ?
Existing antibiotics including Ampicillin (AMP), Cefotaxime (CTX), Cefixime (CFM), Co-trimoxazole (SXT) and Ofloxacin (OFX) were checked for sensitivity by disk diffusion method and findings are given in Table.
Contract award notice: Conclusion of non-exclusive discount agreements pursuant to section 130a (8) sgb v on medicines containing the active substance cefixime (atc code j01dd08) within the period from 1.
Cefixime susceptibility testing was conducted from 2005 through 2006, temporarily halted in 2007 due to lack of availability of cefixime in the United States, and resumed in 2009.
That brings the doctors to what the WHO refers to as "the current last-resort treatment" - the oral cefixime and the injectable ceftriaxone, which are seeing resistance in 66 percent of countries reporting.
For Gram-positive organisms ampicillin, cefoxitin, cefixime, azithromycin, ofloxacin, amikacin, clindamycin, amoxicillin + clavulanic acid, vancomycin, and linezolid were used.
Cefixime is not a first-line regimen treatment for gonorrhea and dual therapy with ceftriaxone and azithromycin is the only recommended first-line regimen.
Overall, 42(93%) strains were sensitive to cefixime and ceftriaxone.
Enhanced gonorrhea susceptibility to third-generation cephalosporin-class antibiotic agents such as injectable ceftriaxone and oral cefixime may have been temporary, according to a retrospective analysis.
In these cases, the sensitivity of urinary pathogens to cefazolin, cefixime, ceftriaxone, ciprofloxacin, gentamicin, nalidixic acid, nitrofurantoin, and cotrimoxazol antibiotics and in the case of gram-positive bacteria to vancomycin, erythromycin, imipenem antibiotics (in addition to the aforementioned antibiotics) in the treatment of urinary tract infections was determined.
Among the sensitive isolates the highest sensitivity has been recorded in case of cefixime and the least sensitivity in case of doxycycline.
Summary: The purpose of the study was to develop a new spectrophotometric method for the determination of cefixime trihydrate using cobalt salts i.
By 2007, the prevalence of QRNG was >5% among GISP isolates collected throughout the United States, prompting CDC to no longer recommend the use of fluoroquinolones for gonorrhea treatment (3) Spectinomycin, an alternative treatment, had not been available in the United States since 2006, so cephalosporins (such as cefixime and ceftriaxone) were the only remaining antimicrobials recommended for treatment of gonococcal infections.