Cefixime

General
  • Type: Third generation cephalosporin
  • Dosage Forms: tablet, chewable tablet, oral suspension
  • Dosage Strengths: tablet: 400mg; chewable tablet: 100, 200mg; oral suspension: 100mg/5mL, 200mg/5mL, 500mg/mL
  • Routes of Administration: PO
  • Common Trade Names: Suprax

Adult Dosing

Pediatric Dosing

Special Populations
  • Pregnancy:
  • Lactation:
  • Renal Dosing
    • Adult
      • CrCl ≥ 60 mL/min: No adjustment
      • CrCl 21 to 59 mL/min:
        • Chewable tablet: not recommended
        • Suspension: 260 mg once daily
      • CrCl ≤ 20
        • Chewable tablet: 200 mg once daily
        • 100 mg/5 mL suspension: 172 mg once daily
        • 200 mg/5 mL suspension: 176 mg once daily
        • 500 mg/5 mL suspension: 180 mg once daily
      • Hemodialysis
        • Chewable tablet: not recommended
        • Suspension: 260 mg once daily
    • Pediatric
      • limited data
      • Mild to moderate impairment - no adjustment
      • Severe impairment and anuric - reduce dose 50%
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications
  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology
  • Half-life: 3-4 hr
  • Metabolism:
  • Excretion: Urine (50% as unchanged drug), feces (10%)
  • Mechanism of Action: arrests bacterial cell wall synthesis

Antibiotic Sensitivities[1]
Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepS
Strep. anginosus gpX1
Enterococcus faecalisR
Enterococcus faeciumX1
MSSAR
MRSAR
CA-MRSAR
Staph. EpidermidisR
C. jeikeiumR
L. monocytogenesR
Gram NegativesN. gonorrhoeaeS
N. meningitidisI
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+R
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negR
Enterobacter sp, AmpC posR
Serratia spI
Serratia marcescensX1
Salmonella spS
Shigella spS
Proteus mirabilisS
Proteus vulgarisS
Providencia sp.S
Morganella sp.R
Citrobacter freundiiR
Citrobacter diversusX1
Citrobacter sp.S
Aeromonas spS
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaR
Stenotrophomonas maltophiliaR
Yersinia enterocoliticaS
Francisella tularensisX1
Brucella sp.X1
Legionella sp.R
Pasteurella multocidaS
Haemophilus ducreyiS
Vibrio vulnificusX1
MiscChlamydophila spX1
Mycoplasm pneumoniaeX1
Rickettsia spX1
Mycobacterium aviumX1
AnaerobesActinomycesX1
Bacteroides fragilisR
Prevotella melaninogenicaS
Clostridium difficileX1
Clostridium (not difficile)R
Fusobacterium necrophorumX1
Peptostreptococcus sp.S

Key
  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References
  1. Sanford Guide to Antimicrobial Therapy 2014

Cefixime: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

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