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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › OTHER BETA-LACTAM ANTIBACTERIALS › Third-generation cephalosporins
cefixime and beta-lactamase inhibitor
J01DD58
Forms & Strengths
- Oral tablet: Cefixime 400 mg / beta-lactamase inhibitor (e.g., clavulanate or equivalent) fixed-dose combination
- Oral suspension: Cefixime 100 mg / 5 mL plus beta-lactamase inhibitor
Adult Dosing
- Uncomplicated urinary tract infections: 400 mg cefixime component orally once daily or divided every 12 hours for 7-14 days
- Gonococcal infections (uncomplicated): 400 mg orally as a single dose combined with appropriate therapy
- Respiratory tract infections: 400 mg orally daily in 1 or 2 divided doses for 7-14 days
Pediatric Dosing
- Children > 6 months (weight < 50 kg): 8 mg/kg/day of cefixime component orally once daily or divided into 4 mg/kg every 12 hours
- Children > 50 kg or > 12 years: Adult dosing of 400 mg daily
Indications
- Uncomplicated urinary tract infections caused by susceptible beta-lactamase-producing organisms
- Acute exacerbations of chronic bronchitis
- Pharyngitis and tonsillitis
- Uncomplicated gonorrhea (cervical/urethral/rectal)
Mechanism of Action
- Cefixime is a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs)
- Beta-lactamase inhibitor protects cefixime from degradation by inactivating plasmid- and chromosome-mediated beta-lactamases
Contraindications
- Known hypersensitivity to cefixime, other cephalosporins, or beta-lactamase inhibitors
- History of severe immediate hypersensitivity reaction (e.g., anaphylaxis) to penicillins or other beta-lactam antibiotics
Adverse Reactions
- Diarrhea and loose stools
- Nausea, abdominal pain, and dyspepsia
- Headache and dizziness
- Transient elevations in serum transaminases and BUN
- Hypersensitivity reactions including rash, urticaria, and pruritus
Drug Interactions
- Probenecid decreases the renal excretion of cefixime, increasing plasma levels
- Anticoagulants (e.g., warfarin): May increase the risk of bleeding due to potential suppression of gut flora producing vitamin K
- False-positive reactions for glucose in urine using non-specific reduction methods
Curated Content: Needs Vetting Before Put to Clinical Use