Cefixime
 | |
| Clinical data | |
|---|---|
| Trade names | Many names worldwide[1] |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a690007 |
| Pregnancy category |
|
| Routes of administration | Oral capsule/suspension |
| ATC code | J01DD08 (WHO) |
| Legal status | |
| Legal status |
|
| Pharmacokinetic data | |
| Bioavailability | 40% to 50% |
| Protein binding | Approximately 60% |
| Biological half-life |
Variable Average 3 to 4 hours |
| Excretion | Renal and biliary |
| Identifiers | |
| |
| CAS Number |
79350-37-1  |
| PubChem (CID) | 5362065 |
| DrugBank |
DB00671 |
| ChemSpider |
4514923 |
| UNII |
XZ7BG04GJX  |
| KEGG |
D00258 |
| ChEBI |
CHEBI:472657 |
| ChEMBL |
CHEMBL1541 |
| ECHA InfoCard | 100.119.331 |
| Chemical and physical data | |
| Formula | C16H15N5O7S2 |
| Molar mass | 453.452 g/mol |
| 3D model (Jmol) | Interactive image |
| |
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| (what is this?) (verify) | |
Cefixime is an antibiotic useful for the treatment of a number of bacterial infections. It is a third generation cephalosporin. It is on the World Health Organization's List of Essential Medicines.[2]
Medical uses
Cefixime treats infections of the:
Ear: Otitis caused by Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes.
Sinuses: Sinusitis.
Throat: Tonsillitis, pharyngitis caused by Streptococcus pyogenes.
Chest and lungs: Bronchitis, pneumonia caused by Streptococcus pneumoniae and Haemophilus influenzae.
It is also used to treat typhoid fever.[3]
Spectrum of bacterial susceptibility
Cefixime is a broad spectrum cephalosporin antibiotic and is commonly used to treat bacterial infections of the ear, urinary tract, and upper respiratory tract. The following represents MIC susceptibility data for a few medically significant microorganisms:[4]
- Escherichia coli: 0.015 µg/mL - 4 µg/mL
- Haemophilus influenzae: ≤0.004 µg/mL - >4 µg/mL
- Proteus mirabilis: ≤0.008 µg/mL - 0.06 µg/mL
Mechanism of action
The bactericidal action of Cefixime is due to the inhibition of cell wall synthesis. It binds to one of the penicillin binding proteins (PBPs) which inhibits the final transpeptidation step of the peptidoglycan synthesis in the bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption
Only 40-50% is absorbed from the GI tract (oral bioavailability). Absorption may be decreased when taken with food. Average peak concentration after administration of oral suspension is approximately 25-50% greater than the peak concentration following oral tablet or capsules administration.[5]
Distribution
It has high concentrations in bile and urine. It can cross the placenta and its protein binding capacity is 65%.
It is always better to perform appropriate cultures and susceptibility studies to determine the causative organism and its sensitivity to cefixime.
Contraindications
Cefixime is contraindicated in patients with known sensitivity or allergies to cephalosporin class of antibiotics. As Cefixime is a third generation cephalosporin, it is not contraindicated for patients with a true penicillin allergy.[6]
Adverse effects
Adverse drug reactions include diarrhea, dyspepsia, nausea and vomiting. Hypersensitivity reactions like skin rashes, urticaria and Stevens-Johnson syndrome have been reported. Though thrombocytopenia has been reported for many cephalosporins, it has not been reported for cefixime. There is no specific antidote for Cefixime overdosage. Gastric lavage may be performed. Dialysis will not remove Cefixime in significant quantities.
Drug Interactions
- Alcohol - No major interaction has been observed between cefixime and alcohol.[7]
History
It was sold under the trade name Suprax 125 in the USA until 2003 when it was taken off the market by drug manufacturer Wyeth after its patent expired.
Trade Names
Cefixime is marketed under many trade names worldwide.[1]
References
- 1 2 Drugs.com International trade names for cefixime Page accessed Feb 26, 2016
- ↑ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
- ↑ "Mechanism of Therapeutic Effectiveness of Cefixime against Typhoid Fever". Antimicrobial Agents and Chemotherapy. September 2001. Retrieved 7 April 2016.
- ↑ http://www.toku-e.com/Assets/MIC/Cefixime%20trihydrate.pdf
- ↑ "SUPRAX Package Insert" (PDF). Lupin Pharmaceuticals, Inc. March 2013. Retrieved 7 April 2016.
- ↑ http://www.cks.nhs.uk/gonorrhoea/prescribing_information/prescribing_information/cephalosporins_ceftriaxone_or_cefixime
- ↑ Choices, N. H. S. "Medicines information links". www.nhs.uk. NHS Choices. Retrieved 22 August 2016.