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# Tab-Genixim (Cefixime) ## Overview Tab-Genixim is a third-generation cephalosporin antibiotic. It possesses broad-spectrum activity against many Gram-negative bacteria and increased stability against beta-lactamases compared to earlier generations. ## Primary Indications - Uncomplicated urinary tract infections (UTIs) - Otitis media - Pharyngitis and tonsillitis - Acute exacerbations of chronic bronchitis - Uncomplicated gonorrhea (cervical/urethral/rectal) ## Adult Dosing - **Standard Infections:** 400 mg daily, administered either as a single dose or in two divided doses of 200 mg every 12 hours. - **Uncomplicated Gonorrhea:** 400 mg as a single oral dose. - **Maximum Dose:** 400 mg per day. ## Pediatric Dosing - **Standard Infections (Children > 6 months or > 50 kg):** 8 mg/kg/day, administered as a single daily dose or in two divided doses of 4 mg/kg every 12 hours. - **Children > 50 kg:** Use adult dosing. - **Maximum Dose:** 400 mg per day. ## Dose Adjustments - **Renal Impairment:** - CrCl 21–60 mL/min: Reduce dose by 25% (or 300 mg daily). - CrCl < 20 mL/min: Reduce dose by 50% (or 200 mg daily). - **Hepatic Impairment:** No specific dose adjustment guidelines are established. ## Contraindications - Known hypersensitivity to cefixime or other cephalosporins. - History of anaphylactic reaction to penicillins or other beta-lactam antibiotics. ## Adverse Effects - **Gastrointestinal:** Diarrhea (common), nausea, abdominal pain, *Clostridioides difficile*-associated diarrhea. - **Dermatologic:** Rash, pruritus, urticaria. - **Neurologic:** Headache, dizziness. - **Other:** Serum sickness-like reactions, transient increases in LFTs. ## Key Drug Interactions - **Anticoagulants (e.g., Warfarin):** May increase the anticoagulant effect/INR; monitor closely. - **Probenecid:** May increase serum concentrations of cefixime by reducing renal excretion. - **BCG Vaccine/Typhoid Vaccine:** Cefixime may diminish the therapeutic effect of these live vaccines. ## Monitoring - Monitor for resolution of clinical symptoms. - Observe for signs of superinfection (e.g., *C. difficile* diarrhea). - In patients on long-term therapy, monitor renal and hepatic function, and perform periodic CBC. ## Clinical Pearls - Food does not significantly affect the absorption of cefixime tablets. - Note that oral suspension and tablets may not be bioequivalent; verify formulation before prescribing. - If a patient has a history of mild penicillin allergy (e.g., non-anaphylactic rash), cephalosporins may be used with caution, but they remain contraindicated in patients with a history of IgE-mediated anaphylaxis to penicillins. *** **Educational Disclaimer:** This information is for educational purposes only. Clinical practice and dosing protocols may vary based on local infectious disease guidelines and antibiotic stewardship programs. Always verify the most current prescribing information, patient-specific renal function, and drug-drug interaction databases before initiating therapy.