Classifications: antibiotic, beta-lactam; third-generation cephalosporin; Therapeutic:antibiotic; cephalosporin
Prototype: Cefotaxime sodium
Pregnancy Category: B
100 mg/5 mL, 200 mg/5 mL suspension
Cefixime is a third-generation cephalosporin. As a beta-lactam antibiotic like the penicillins, it is mainly bactericidal.
It inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding
proteins (PBPs) located inside the bacterial cell wall.
Cefixime is highly stable in the presence of beta-lactamases (penicillinases and cephalosporinases) and therefore has excellent
activity against a wide range of gram-negative bacteria. It is bactericidal against susceptible bacteria.
Effective against Streptococcus pyogenes, Streptococcus pneumoniae, and gram-negative bacilli, including Haemophilus influenzae, Branhamella catarrhalis, and Neisseria gonorrhoeae. Little activity against Staphylococci, and no activity against Pseudomonas aeruginosa; also uncomplicated UTI, otitis media, pharyngitis, tonsillitis, and bronchitis.
Patients with known allergy to the cephalosporin group of antibiotics, severe reaction to penicillin.
Allergy to penicillin, history of colitis, renal insufficiency, GI disease, coagulopathy, pregnancy (category B), lactation.
Safety and effectiveness in infants <6 mo have not been established.
Route & Dosage
Adult: PO 400 mg/d in 12 divided doses
Child: PO 8 mg/kg/d in 12 divided doses
- Do not substitute tablets for liquid in treatment of otitis media because of lack of bioequivalence.
- After reconstitution, suspension may be kept for 14 d at room temperature or refrigerated. Store away from heat and light.
Keep tightly closed and shake well before using.
Adverse Effects (≥1%) GI: Diarrhea,
loose stools, nausea, vomiting, dyspepsia, flatulence. CNS:
Drug fever, headache, dizziness. Skin:
Rash, pruritus, Urogenital: Vaginitis
, genital pruritus.
may increase risk of nephrotoxicity and have additive/synergistic effects. May decrease efficacy of oral contraceptives
may increase levels.
4050% from GI tract. Peak:
26 h. Distribution:
Into breast milk. Elimination:
50% in urine, 50% in bile. Half-Life:
Assessment & Drug Effects
- Determine previous hypersensitivity reactions to cephalosporins, penicillins, and history of other allergies, particularly
to drugs prior to initiation of therapy.
- Lab tests: Perform culture and sensitivity tests prior to initiation of therapy and periodically during therapy. Therapy
may be implemented pending test results.
- Discontinue if seizures associated with the drug therapy occur.
- Monitor for superinfections (see Appendix F) caused by overgrowth of nonsusceptible organisms, particularly during prolonged
- Monitor I&O rates and pattern: Nephrotoxicity occurs more frequently in patients >50 y, with impaired renal function, in
the debilitated, and in patients receiving high doses or other nephrotoxic drugs.
- Carefully monitor anyone with a history of allergies, especially to drugs. Report manifestations of hypersensitivity (see
- Promptly report loose stools or diarrhea, which may indicate pseudomembranous colitis (see Appendix F). Discontinuation of
drug may be necessary.
Patient & Family Education
- Report loose stools or diarrhea during drug therapy and for several weeks after. Older adult patients are especially susceptible
to pseudomembranous colitis.
- Take this antibiotic for the full course of treatment.
- Do not miss any doses and take the doses at evenly spaced times, day and night.