CEFIXIME

Antibacterial activity

Cephalosporin, third generation
Effective against gram-negative 
Limited gram-positive coverage (eg. Strep. pneumonia/pyogenes/viridans)
Limited anaerobic coverage 

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to cefixime, other cephalosporins or any component
Use caution if previous penicillins hypersensitivity:  10% of patient may have cross-hypersensitivity to cephalosporins
Use caution if renal dysfunction or other nephrotoxic agents used
Use caution if history of ATB related colitis
Use caution if seizure disorder
Safety and efficacy have not been established in children up to 6 months of age

Mechanism of Action

Inhibits cell wall synthesis (bactericidal)

Pharmacodynamics

Metabolism: N/A
Half-life: 3-4 hours, changes with renal function
Elimination: excreted in urine mostly, also in bile

Dosage

Children:  

> 28 days old: 
8 mg/kg/d PO div bid or qd

Adults:

400 mg/day PO div bid or qd

Dose VS renal function

Cr. clearance (ml/min):
<10: 400 mg PO q48h or 200 mg PO q24h 10-50: 300 mg PO q24h 50-80: unchanged >80: unchanged

Dialysis
Hemo:  400 mg PO q48h or 200 mg PO q24h
CAPD: 400 mg PO q48h or 200 mg PO q24h