Tab%252520genixim

# Tabgenixim (Cefixime) ## Overview Cefixime is a third-generation cephalosporin antibiotic. It possesses broad-spectrum activity against Gram-negative organisms and stable resistance to many beta-lactamases, though its activity against *Staphylococcus aureus* is poor. ## Primary Indications * Uncomplicated urinary tract infections (UTIs) * Otitis media * Pharyngitis and tonsillitis * Uncomplicated gonorrhea (cervical, urethral, and rectal) ## Adult Dosing * **Respiratory/UTI:** 400 mg daily as a single dose or divided into 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 dose or divided into 4 mg/kg every 12 hours. * **Maximum Dose:** 400 mg/day. * **Note:** Dosing varies by local protocol and weight-based guidelines; always confirm with current pediatric references (e.g., Harriet Lane). ## Dose Adjustments * **Renal Impairment:** If CrCl <60 mL/min, dose reduction is required. * CrCl 21–60 mL/min: Reduce dose by 25% or increase interval to every 24 hours. * CrCl <20 mL/min: Reduce dose by 50% or increase interval to every 24 hours. * **Hepatic Impairment:** No specific adjustment necessary. ## 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 (CDAD), hypersensitivity reactions (rash, urticaria), Stevens-Johnson syndrome, and secondary fungal infections. ## Key Drug Interactions * **Anticoagulants:** May increase the anticoagulant effect of warfarin (monitor INR). * **Probenecid:** Increases serum concentrations of cefixime by inhibiting renal excretion; monitor for toxicity. * **Vaccines:** May decrease the efficacy of the BCG vaccine or Typhoid vaccine; separate administration. ## Monitoring * Monitor for signs of anaphylaxis during the first dose. * Monitor stool frequency/consistency if diarrhea develops to rule out *C. difficile*. * Renal function (BUN/SCr) in patients with pre-existing impairment. ## Clinical Pearls * Cefixime has poor activity against *S. pneumoniae*; it should not be used as empiric therapy for suspected pneumococcal pneumonia. * The suspension form (often strawberry-flavored) is preferred for pediatrics; do not refrigerate if the manufacturer label specifies storage at room temperature, though common practices vary. * Bioavailability is similar regardless of food intake, though some patients tolerate the medication better when taken with food. *** *Disclaimer: This information is for educational purposes only. Always verify dosing, contraindications, and drug interactions against current institutional protocols, the drug manufacturer's prescribing information, or standardized resources like Lexicomp or Micromedex before prescribing.*