Cefixime%25252525252525252525252525252525252525252525252525252525252525252525252525252520trihidrate

# Cefixime trihydrate ## Overview Cefixime trihydrate is a third-generation cephalosporin antibiotic effective against a variety of Gram-positive and Gram-negative bacteria. It is administered orally. ## Primary Indications * Acute bacterial exacerbations of chronic bronchitis * Acute otitis media * Acute urinary tract infections * Shigellosis * Typhoid fever ## Adult Dosing * **Uncomplicated urinary tract infections, acute otitis media, acute bacterial exacerbations of chronic bronchitis:** 400 mg once daily or 200 mg every 12 hours. * **Shigellosis, typhoid fever:** 400 mg once daily. * Maximum dose: 400 mg daily. ## Pediatric Dosing * **Acute otitis media, uncomplicated urinary tract infections:** 8 mg/kg/day once daily or divided every 12 hours. * **Shigellosis:** 10 mg/kg/day once daily. * Maximum dose for children weighing >50 kg: 400 mg/day. * Maximum dose for children weighing <=50 kg: 8 mg/kg/day (or 10 mg/kg/day for shigellosis). * Dosing for infants younger than 6 months is not well established. ## Dose Adjustments No dose adjustment is typically required for renal impairment unless the creatinine clearance is less than 30 mL/min. In such cases, the usual dose should be given every 24 hours. For patients on hemodialysis, the usual dose should be given every 24 hours. ## Contraindications * Hypersensitivity to cefixime, other cephalosporins, or any component of the formulation. ## Adverse Effects Common: Diarrhea, nausea, vomiting, abdominal pain, headache, rash. Serious: *Clostridioides difficile*-associated diarrhea, Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures, hypersensitivity reactions including anaphylaxis, cholestatic jaundice, hepatic dysfunction, renal impairment. ## Key Drug Interactions * **Carbamazepine:** Cefixime may increase carbamazepine levels. Monitor carbamazepine concentrations. * **Warfarin:** Cefixime may alter prothrombin time. Monitor INR. * **BCG vaccine (intravesical):** Cephalosporins can reduce the efficacy of BCG. Do not administer concurrently. ## Monitoring * Monitor for signs and symptoms of hypersensitivity reactions. * Monitor for signs and symptoms of *Clostridioides difficile*-associated diarrhea. * Monitor renal function if clinically indicated. ## Clinical Pearls * Administer with or without food. * Shake oral suspension well before each use. * For shigellosis and typhoid fever, a full course of therapy is essential. * Resistance to cefixime may be high in certain geographic areas; consult local susceptibility data. Please verify current prescribing information before use.