Please check your internet connection and try again.
# Tigenixim (Cefixime)
## Overview
Cefixime is a third-generation cephalosporin antibiotic. It possesses broad-spectrum activity against many Gram-negative bacteria (including *Neisseria gonorrhoeae*, *Haemophilus influenzae*, and *Moraxella catarrhalis*) and limited activity against Gram-positive organisms (e.g., *Streptococcus pneumoniae*).
## Primary Indications
* Uncomplicated gonorrhea (cervical, urethral, and rectal).
* Otitis media.
* Pharyngitis and tonsillitis.
* Acute exacerbations of chronic bronchitis.
* Uncomplicated urinary tract infections (UTIs).
## Adult Dosing
* **Gonorrhea:** 800 mg orally as a single dose (note: CDC guidelines currently recommend 500 mg IM ceftriaxone as first-line; cefixime is an alternative if ceftriaxone is not available).
* **Other infections:** 400 mg orally daily (either as a single dose or divided into 200 mg every 12 hours).
## Pediatric Dosing
* **General infections:** 8 mg/kg/day orally as a single dose or divided into 4 mg/kg every 12 hours.
* **Maximum dose:** 400 mg per day.
* **Note:** Safety and efficacy have not been established for children under 6 months of age.
## Dose Adjustments
* **Renal Impairment:** If CrCl is 21–60 mL/min, administer 75% of the standard dose. If CrCl is <20 mL/min, administer 50% of the standard dose.
* **Hepatic Impairment:** No specific manufacturer dosage adjustments are provided.
## Contraindications
* Known hypersensitivity to cefixime or other cephalosporins.
* History of anaphylaxis to beta-lactam antibiotics (penicillins or carbapenems).
## Adverse Effects
* **Common:** Diarrhea (most frequent), abdominal pain, nausea, dyspepsia, and flatulence.
* **Serious:** *Clostridioides difficile*-associated diarrhea (CDAD), hypersensitivity reactions (anaphylaxis, serum sickness), and seizures (in patients with renal impairment).
## Key Drug Interactions
* **Warfarin/Anticoagulants:** May enhance the effects of anticoagulants; monitor INR closely.
* **Probenecid:** Can increase serum levels of cefixime by inhibiting renal excretion.
* **Vaccines:** May decrease the therapeutic effect of the BCG vaccine or typhoid vaccine.
## Monitoring
* Monitor for signs of hypersensitivity.
* Assess for persistent diarrhea (rule out *C. difficile*).
* Monitor renal function in patients with pre-existing renal impairment.
## Clinical Pearls
* Cefixime suspension and tablets are not bioequivalent on a mg-per-mg basis; refer to specific product labeling if switching formulations.
* The drug is not effective against *Staphylococcus aureus* or *Pseudomonas aeruginosa*.
* Diarrhea is common and dose-related; taking the medication with food may minimize gastrointestinal upset.
***
**Educational Disclaimer:** This information is for educational purposes only. Clinical practice guidelines vary by region and institution. Always verify specific dosing, safety warnings, and contraindications via the latest manufacturer prescribing information (package insert) or institutional pharmacy protocols before prescribing or administering medication.
