Tab%25252525252525252525252520genixim

# Cefixime (Suprax) ## Overview Cefixime is a third-generation cephalosporin antibiotic. It possesses broad-spectrum activity against many Gram-negative bacteria and stable resistance to beta-lactamase degradation. It is available as oral tablets, chewable tablets, and oral suspension. ## Primary Indications - Uncomplicated urinary tract infections (UTIs) - Otitis media - Pharyngitis and tonsillitis - Uncomplicated gonorrhea (urethral, cervical, rectal) - Acute exacerbations of chronic bronchitis ## Adult Dosing - **General infections:** 400 mg daily, administered either as a single dose or in two divided doses of 200 mg every 12 hours. - **Uncomplicated gonorrhea:** 800 mg as a single oral dose (note: CDC guidelines currently recommend ceftriaxone 500 mg IM as the preferred treatment; cefixime is an alternative if ceftriaxone is unavailable). ## Pediatric Dosing - **General infections (≥6 months):** 8 mg/kg/day administered as a single daily dose or in two divided doses of 4 mg/kg every 12 hours. - **Maximum dose:** 400 mg/day. ## Dose Adjustments - **Renal Impairment:** - CrCl 21–60 mL/min: Reduce dose by 25%. - CrCl <20 mL/min: Reduce dose by 50%. - **Hepatic Impairment:** No specific dosage adjustments established. ## Contraindications - Known hypersensitivity to cefixime or other cephalosporins. - History of severe hypersensitivity (anaphylaxis) to penicillins or other beta-lactams (use with extreme caution or avoid). ## Adverse Effects - **Common:** Diarrhea (frequent, dose-related), abdominal pain, nausea, dyspepsia. - **Serious:** *Clostridioides difficile*-associated diarrhea (CDAD), hypersensitivity reactions (rash, urticaria, serum sickness), and rare cases of Stevens-Johnson syndrome or toxic epidermal necrolysis. ## Key Drug Interactions - **Anticoagulants:** May increase the anticoagulant effect of warfarin (vitamin K synthesis inhibition by gut flora). - **Probenecid:** Increases serum concentrations of cefixime by inhibiting renal tubular secretion. - **Carbamazepine:** Cefixime may potentially increase carbamazepine levels; monitor for toxicity if used concomitantly. ## Monitoring - Monitor for resolution of symptoms. - Assess for signs of superinfection (e.g., persistent watery or bloody stools suggestive of *C. difficile*). - Periodic renal function monitoring in patients on long-term or high-dose therapy. ## Clinical Pearls - **Bioavailability:** The oral suspension has higher bioavailability than the tablets; switching between formulations is not strictly bioequivalent. - **Administration:** Can be taken with or without food. - **Spectrum:** Poor activity against *Staphylococcus aureus* compared to first-generation cephalosporins; it does not cover *Pseudomonas aeruginosa*. - **Local Protocol:** Always verify gonorrhea treatment regimens against current local antibiograms and CDC STI treatment guidelines, as resistance patterns change frequently. *** *Disclaimer: This information is for educational purposes only. Clinical practice guidelines and local resistance patterns evolve. Always verify current prescribing information in a trusted clinical resource (e.g., Lexicomp, UpToDate) and adhere to local institutional protocols before prescribing or administering medication.*