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# Cefixime (Genixim)
## Overview
Cefixime is a third-generation cephalosporin antibiotic. It possesses extended-spectrum activity against Gram-negative bacteria (including *Haemophilus influenzae* and *Moraxella catarrhalis*) and limited activity against Gram-positive organisms (e.g., *Streptococcus pneumoniae*). It is stable against many beta-lactamases.
## Primary Indications
* Uncomplicated urinary tract infections (UTIs)
* Otitis media
* Pharyngitis and tonsillitis
* Uncomplicated gonorrhea (cervical, urethral, and rectal)
* Acute exacerbations of chronic bronchitis
## Adult Dosing
* **General infections:** 400 mg daily, administered either as a single dose or in two divided doses (200 mg every 12 hours).
* **Uncomplicated gonorrhea:** 800 mg as a single oral dose (Note: Local resistance patterns vary; check current CDC or local guidelines).
## Pediatric Dosing
* **General infections (Children >6 months):** 8 mg/kg/day administered as a single dose or in two divided doses (4 mg/kg every 12 hours).
* **Maximum daily dose:** 400 mg.
## Dose Adjustments
* **Renal Impairment:** If CrCl is 21–60 mL/min, administer 75% of the standard dose. If CrCl <20 mL/min, administer 50% of the standard dose. hemodialysis/peritoneal dialysis patients usually do not require supplemental doses.
## Contraindications
* Known severe hypersensitivity (e.g., anaphylaxis) to cefixime or other cephalosporins.
* History of severe allergic reactions to penicillins (due to potential cross-reactivity).
## Adverse Effects
* **Gastrointestinal:** Diarrhea (most common, dose-dependent), nausea, abdominal pain, dyspepsia.
* **Dermatologic:** Rash, pruritus, urticaria.
* **Other:** Dizziness, headache, pseudomembranous colitis (rare but serious), elevated liver enzymes.
## Key Drug Interactions
* **Anticoagulants:** May increase the anticoagulant effect of warfarin (monitor INR).
* **Probenecid:** May increase serum concentrations of cefixime by reducing renal tubular secretion.
* **Vaccines:** May decrease the efficacy of live typhoid vaccine.
## Monitoring
* Monitor for signs of hypersensitivity or anaphylaxis during initial doses.
* In prolonged therapy, monitor renal and hepatic function.
* Assess for persistent diarrhea (rule out *Clostridioides difficile*).
## Clinical Pearls
* Cefixime is generally not effective against *Staphylococcus aureus* or *Enterococcus* species.
* Take with or without food; taking with food may help mitigate gastrointestinal side effects.
* Oral suspension must be shaken well before use.
* **Note:** Dosing protocols for gonorrhea are subject to rapid change based on regional antibiotic susceptibility patterns. Always refer to the most recent clinical guidelines (e.g., CDC STD Treatment Guidelines).
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**Educational Disclaimer:** This information is for educational purposes only. Clinical practice guidelines and local resistance patterns may vary. Always verify specific dosing, safety profiles, and prescribing information using your institution's formulary, current package inserts, or clinical decision support tools before administering therapy.
