Please check your internet connection and try again.
# Cefixime Trihydrate
## Overview
Cefixime is a third-generation cephalosporin antibiotic that is acid-stable and orally administered. It possesses broad-spectrum activity against many Gram-negative bacteria (including *Haemophilus influenzae*, *Moraxella catarrhalis*, and *Neisseria gonorrhoeae*) but has limited activity against *Staphylococcus aureus*.
## Primary Indications
* Uncomplicated urinary tract infections (UTIs)
* Otitis media
* Pharyngitis and tonsillitis
* 急性 exacerbations of chronic bronchitis
* Uncomplicated gonorrhea (cervical, urethral, and rectal)
## Adult Dosing
* **Respiratory/UTI/Pharyngitis:** 400 mg daily, administered either as a single dose or in two divided doses (200 mg every 12 hours).
* **Uncomplicated Gonorrhea:** 800 mg orally as a single dose.
## Pediatric Dosing
* **General Infections (> 6 months):** 8 mg/kg/day orally as a single daily dose or divided into two doses of 4 mg/kg every 12 hours.
* **Otitis Media:** 8 mg/kg/day.
* *Note:* Suspension should be used for accurate weight-based dosing.
## Dose Adjustments
* **Renal Impairment:**
* CrCl 21–60 mL/min: Reduce dose to 75% of the standard dose (give 300 mg daily).
* CrCl < 20 mL/min or hemodialysis: Reduce dose to 50% of the standard dose (give 200 mg daily).
* **Hepatic Impairment:** No specific adjustment required.
## Contraindications
* Known hypersensitivity to cefixime or other cephalosporins.
* History of severe allergic reaction (e.g., anaphylaxis) to penicillins or other beta-lactams.
## Adverse Effects
* **Common:** Diarrhea (frequently dose-related), abdominal pain, nausea, dyspepsia.
* **Serious:** *Clostridioides difficile*-associated diarrhea, hypersensitivity reactions (rash, urticaria), seizures (rare, mostly in renal impairment), and potential for superinfection.
## Key Drug Interactions
* **Anticoagulants:** May enhance the effects of warfarin (monitor INR).
* **Probenecid:** May increase serum levels of cefixime by reducing renal tubular secretion.
* **Vaccines:** May decrease the therapeutic effect of BCG vaccine or Typhoid vaccine (separate timing).
## Monitoring
* Monitor for signs of anaphylaxis during the first dose.
* Assess for persistent diarrhea (rule out *C. difficile*).
* In long-term therapy, monitor renal and hepatic function.
## Clinical Pearls
* **Bioavailability:** Suspension has higher bioavailability than equivalent doses of tablet form; avoid interchanging interchangeably if possible.
* **Food:** Can be taken with or without food.
* **Spectrum:** Poor activity against *S. aureus*; do not use for skin/soft tissue infections suspected to be caused by staphylococci.
* **Gonorrhea:** Due to increasing resistance, follow current CDC guidelines, which may require combination therapy or dual-agent regimens for gonorrhea.
***
**Educational Disclaimer:** This information is for educational purposes only. Always verify dosing, contraindications, and drug-drug interactions with the most current institutional protocols, manufacturers' prescribing information, or a current clinical drug database (e.g., Lexicomp, UpToDate) before prescribing or administering medication.
