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# Cefixime Trihydrate
## Overview
Cefixime is a third-generation cephalosporin antibiotic with broad-spectrum activity against many Gram-positive and Gram-negative bacteria. It is administered orally.
## Primary Indications
* Acute otitis media
* Acute bacterial sinusitis
* Acute exacerbations of chronic bronchitis
* Uncomplicated urinary tract infections
* Pharyngitis/tonsillitis
* Uncomplicated gonorrhea
## Adult Dosing
* **General Adult Dosing:** 400 mg once daily or 200 mg every 12 hours.
* **Uncomplicated Gonorrhea:** 400 mg as a single dose.
* **Maximum Dose:** 400 mg daily.
## Pediatric Dosing
* **Age < 6 months:** Safety and efficacy not established.
* **Age ≥ 6 months:** 8 mg/kg/day once daily or 4 mg/kg every 12 hours.
* **Maximum Pediatric Dose:** 400 mg/day.
## Dose Adjustments
* **Renal Impairment:** Dose reduction may be necessary in severe renal impairment. Specific recommendations depend on the calculated creatinine clearance (CrCl). If CrCl < 30 mL/min, consider reducing the dose by 25% or administering every 24 hours instead of every 12 hours.
## Contraindications
* Known hypersensitivity to cefixime, other cephalosporins, or any component of the formulation.
* History of immediate or severe allergic reaction to penicillin.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, headache.
* **Serious:** Clostridioides difficile-associated diarrhea, severe allergic reactions (anaphylaxis), Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures.
## Key Drug Interactions
* **Probenecid:** May increase cefixime plasma concentrations.
* **Warfarin:** Monitor INR closely; cephalosporins may potentially potentiate the effect of warfarin.
* **Carbamazepine:** Cefixime may decrease carbamazepine levels.
## Monitoring
* Monitor for signs and symptoms of hypersensitivity reactions.
* Monitor for recurrence of infection or development of resistance.
* Monitor stool for C. difficile-associated diarrhea.
* Monitor INR if patient is on warfarin.
## Clinical Pearls
* Administer with or without food.
* Shake suspension well before each use.
* Use in patients with penicillin allergy should be cautioned due to potential cross-reactivity, although cross-reactivity is less common with later-generation cephalosporins.
* Culture and susceptibility testing are recommended prior to initiating treatment for severe infections or when resistance is suspected.
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**Disclaimer:** This information is intended for educational purposes and does not substitute for professional medical advice. Always consult the most current prescribing information and your healthcare provider for any questions regarding medication use.
