Formulary
Cefixime: Indications, Dosing, Side Effects and Interactions
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
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Cefixime: Indications, Dosing, Side Effects and Interactions
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
Drug action
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
Indications and dose
**Acute infections due to sensitive Gram-positive and Gram-negative bacteria**
- **Child** (By Mouth): 10-17 years 200-400 mg daily, alternatively 100-200 mg twice daily.
- **Adult** (By Mouth): 200-400 mg daily in 1-2 divided doses.
**Uncomplicated gonorrhoea [anogenital and pharyngeal infection, when sensitivity confirmed-in combination with azithromycin]**
- **Adult** (By Mouth): 400 mg for 2 doses, the second dose to be given 6-12 hours after the first dose.
**Disseminated gonococcal infection [arthritis and arthritis-dermatitis syndrome, when sensitivity confirmed]**
- **Adult** (By Mouth): 800 mg twice daily, to be used following parenteral ceftriaxone treatment, starting 24-48 hours after symptoms improve, to give 7 days treatment in total.
**Acute infections due to sensitive Gram-positive and Gram-negative bacteria for cefixime**
- **Child 6-11 months** (By mouth): 75 mg daily.
- **Child 1-4 years** (By mouth): 100 mg daily.
- **Child 5-9 years** (By mouth): 200 mg daily.
- **Child 10-17 years** (By mouth): 200-400 mg daily, alternatively 100-200 mg twice daily.
**Uncomplicated gonorrhoea [anogenital and pharyngeal infection, when sensitivity confirmed-in combination with azithromycin] for cefixime**
- **Child 12-17 years (body-weight 45 kg and above)** (By mouth): 400 mg for 2 doses, the second dose to be given 6-12 hours after the first dose.
**Disseminated gonococcal infection [arthritis and arthritis-dermatitis syndrome, when sensitivity confirmed] for cefixime**
- **Child 12-17 years (body-weight 45 kg and above)** (By mouth): 800 mg twice daily, to be used following parenteral ceftriaxone treatment, starting 24-48 hours after symptoms improve, to give 7 days treatment in total.
Side effects
Common or very common Abdominal pain; diarrhoea; dizziness; eosinophilia; headache; leucopenia; nausea; neutropenia; pseudomembranous enterocolitis; skin reactions; thrombocytopenia; vomiting Uncommon Anaphylactic reaction; angioedema Rare or very rare Agranulocytosis; haemolytic anaemia; nephritis tubulointerstitial (reversible); severe cutaneous adverse reactions (SCARs) Side-effects For cefixime Frequency not known Acute kidney injury; arthralgia; drug fever; dyspepsia; dyspnoea; face oedema; flatulence; genital pruritus; hypereosinophilia; jaundice; serum sickness-like reaction; thrombocytosis; vulvovaginal infection
Interactions
**Other interactions (5):**
- Anticoagulants In common with other cephalosporins, increases in prothrombin times have been noted in a few patients.
- Cefixime should be administered with caution to patients receiving coumarin-type anticoagulants, e.g.
- Since cefixime may enhance effects of the anticoagulants, prolonged prothrombin time with or without bleeding may occur.
- Other forms of interaction A false positive reaction for glucose in the urine may occur with Benedict's or Fehling's solutions or with copper sulphate test tablets, but not with tests based on...
- A false positive direct Coombs test has been reported during treatment with cephalosporin antibiotics, therefore it should be recognised that a positive Coombs test may be due to the drug.
Pregnancy
Not known to be harmful.
Breast feeding
Manufacturer advises avoid unless essential-no information available.
Renal impairment
Caution in severe impairment. M Dose adjustments See Prescribing in renal impairment . In adults: Reduce dose if creatinine clearance less than 20 mL/minute (max. 200 mg once daily). M In children: Reduce dose if creatinine clearance less than 20 mL/minute (should not exceed 200 mg once daily). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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