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# Cefixime trihydrate
## Overview
Cefixime is a third-generation cephalosporin antibiotic effective against many gram-positive and gram-negative bacteria. It is administered orally.
## Primary Indications
* Acute otitis media
* Urinary tract infections
* Pharyngitis/tonsillitis
* Uncomplicated gonorrhea
## Adult Dosing
* **General:** 400 mg once daily or 200 mg every 12 hours.
* **Uncomplicated Gonorrhea:** 400 mg as a single dose.
## Pediatric Dosing
* **General:** 8 mg/kg/day once daily or 4 mg/kg every 12 hours.
* **Maximum Daily Dose:** 400 mg.
* **Acute Otitis Media:** 8 mg/kg/day once daily for 5-7 days or 4 mg/kg every 12 hours for 10 days.
* **Note:** For infants < 6 months, dosing and safety are not well established. Consult specific guidelines.
## Dose Adjustments
* **Renal Impairment:** No dose adjustment needed if creatinine clearance (CrCl) is > 60 mL/min. If CrCl is 11-60 mL/min, use the standard dose once daily. If CrCl is < 10 mL/min or patient is on hemodialysis, administer 200 mg once daily or 100 mg every 12 hours, irrespective of hemodialysis status.
## Contraindications
* Hypersensitivity to cefixime, other cephalosporins, or any component of the formulation.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, headache.
* **Serious:** *Clostridioides difficile*-associated diarrhea, hypersensitivity reactions (including anaphylaxis), Stevens-Johnson syndrome, toxic epidermal necrolysis, seizure, hepatic dysfunction, renal dysfunction.
## Key Drug Interactions
* **Warfarin:** Monitor INR.
* **BCG Vaccines:** Decreased efficacy.
## Monitoring
* Monitor for signs and symptoms of hypersensitivity reactions.
* Monitor for *C. difficile*-associated diarrhea.
* Monitor renal function in patients with impaired renal function.
## Clinical Pearls
* Cefixime may be taken with or without food.
* Discontinue immediately if a severe allergic reaction occurs.
* Consider potential for cross-reactivity in patients with penicillin allergy, though risk is lower with third-generation cephalosporins.
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*Disclaimer: This information is intended for healthcare professionals. Always verify current prescribing information and consult relevant clinical guidelines before initiating therapy. Pediatric dosing may vary based on specific indications and local protocols.*
