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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 exacerbations of chronic bronchitis
* Acute uncomplicated urinary tract infections
* Uncomplicated gonorrhea
## Adult Dosing
* **General:** 400 mg once daily, or 200 mg every 12 hours.
* **Gonorrhea:** 400 mg as a single dose.
* **Maximum:** Not to exceed 400 mg daily (except for gonorrhea).
## Pediatric Dosing
* **General:** 8 mg/kg/day once daily or 4 mg/kg/dose every 12 hours.
* **Maximum:** Not to exceed 400 mg daily.
* **Note:** Dosing for children is traditionally based on weight. Consult specific product labeling or local guidelines for exact mg/kg recommendations for various age groups.
## Dose Adjustments
* **Renal Impairment:** Dose reduction may be necessary in severe renal impairment (creatinine clearance < 30 mL/min). Specific adjustments depend on the degree of impairment and local guidelines.
* **Hepatic Impairment:** No dose adjustment is typically required.
## Contraindications
* Hypersensitivity to cefixime, other cephalosporins, penicillins, or any component of the formulation.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, headache.
* **Serious:** Clostridium difficile-associated diarrhea, hypersensitivity reactions (including anaphylaxis), Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures (rare).
## Key Drug Interactions
* **Probenecid:** May increase cefixime plasma concentrations.
* **Carbamazepine:** Cefixime may decrease carbamazepine levels.
* **Warfarin:** Monitor INR closely; cefixime may alter anticoagulation.
## Monitoring
* Monitor for signs and symptoms of hypersensitivity reactions.
* Monitor for diarrhea; consider C. difficile testing if persistent or severe.
* Monitor renal function in patients with impaired renal function.
## Clinical Pearls
* Administer with or without food.
* Ensure adequate hydration.
* Shake oral suspension well before use and store appropriately.
* Consider resistance patterns for common pathogens in the chosen indication.
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**Disclaimer:** This information is intended for clinical use and is not a substitute for professional medical advice. Always consult the most current prescribing information and institutional protocols for complete details and to confirm drug appropriateness for individual patients.
