Please check your internet connection and try again.
# Cefixime (Tabgenixim)
## Overview
Cefixime is a third-generation oral cephalosporin antibiotic. It possesses broad-spectrum activity against Gram-negative bacteria (including *Neisseria gonorrhoeae*, *Haemophilus influenzae*, and *Moraxella catarrhalis*) but has limited activity against *Staphylococcus aureus*.
## Primary Indications
* Uncomplicated gonorrhea (cervical, urethral, and rectal).
* Otitis media.
* Pharyngitis and tonsillitis.
* Acute exacerbations of chronic bronchitis.
* Uncomplicated urinary tract infections.
## Adult Dosing
* **Gonorrhea:** 800 mg orally as a single dose.
* **Respiratory/UTI:** 400 mg daily (administered as a single 400 mg dose or 200 mg every 12 hours).
## Pediatric Dosing
* **Standard dose:** 8 mg/kg/day orally, administered as a single dose or in two divided doses every 12 hours.
* **Maximum:** 400 mg/day.
## Dose Adjustments
* **Renal Impairment (CrCl < 20 mL/min):** Do not exceed 200 mg once daily. Hemodialysis and peritoneal dialysis do not remove significant amounts of cefixime; no supplemental dose post-dialysis is required.
## Contraindications
* Known hypersensitivity to cefixime or other cephalosporins.
* History of severe allergic reactions (e.g., anaphylaxis) to penicillins or other beta-lactams is a relative contraindication due to potential cross-reactivity.
## Adverse Effects
* **Common:** Diarrhea (frequently dose-related), abdominal pain, nausea, dyspepsia.
* **Serious:** *Clostridioides difficile*-associated diarrhea, hypersensitivity reactions (rash, urticaria), seizures (rare, primarily in renal insufficiency), and severe cutaneous adverse reactions (SCARs).
## Key Drug Interactions
* **Anticoagulants:** May enhance the effects of warfarin (monitor INR).
* **Probenecid:** Increases serum concentrations of cefixime by reducing renal tubular secretion.
## Monitoring
* Monitor for signs of *C. difficile* diarrhea (persistent watery/bloody stools).
* Assess renal function periodically in patients on long-term therapy.
* Monitor for signs of hypersensitivity.
## Clinical Pearls
* **Bioavailability:** Suspension provides higher bioavailability than tablets; if switching forms, note that doses may not be perfectly interchangeable.
* **Spectrum limitation:** Cefixime is not effective against *Staphylococcus aureus* or *Enterococcus* species.
* **Administration:** May be taken with or without food.
* **Gonorrhea:** Due to emerging resistance, local gonococcal susceptibility patterns must be reviewed; follow current CDC/local guidelines for dual-therapy requirements (e.g., ceftriaxone 500mg IM is frequently preferred over oral regimens).
***
**Educational Disclaimer:** This information is for educational purposes only. Prescribing practices and susceptibility patterns vary by region and clinical institution. Always verify dosages, contraindications, and drug interactions against the most current prescribing information (e.g., FDA-approved label or institutional formulary) before administration.
