Cefixime, sold under the brand name Suprax among others, is an antibiotic medication used to treat a number of bacterial infections.[ These infections include otitis media, strep throat, pneumonia, urinary tract infections, gonorrhea, and Lyme disease.][ For gonorrhea typically only one dose is required.][ It is taken by mouth.][
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Common side effects include diarrhea, abdominal pain, and nausea.[ Serious side effects may include Allergy and Clostridioides difficile diarrhea.][ It is not recommended in people with a history of a severe penicillin allergy.][ It appears to be relatively safe during pregnancy.][ It works by disrupting the bacteria's cell wall resulting in its death.]
Cefixime was patented in 1979 and approved for medical use in the United States in 1989.
Medical uses
Cefixime treats infections of the:
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Urinary tract: Uncomplicated urinary tract infections caused by susceptible isolates of Escherichia coli and Proteus mirabilis.
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Ear: Otitis media caused by Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes.
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Throat: Tonsillitis and pharyngitis caused by Streptococcus pyogenes.
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Chest and lungs: Chronic bronchitis caused by Streptococcus pneumoniae and Haemophilus influenzae.
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Cervix and urethra: Gonorrhea (cervical/urethral) caused by susceptible isolates of Neisseria gonorrhoeae (penicillinase-and non-penicillinase-producing isolates).
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Skin and soft tissue infection: effective against group A and B beta-hemolytic streptococci. However, Staphylococcus aureus, coagulase-negative staphylococci and enterococci are resistant.
It is also used to treat typhoid fever.[
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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:
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Escherichia coli: 0.015 μg/mL – 4 μg/mL
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Haemophilus influenzae: ≤0.004 μg/mL – >4 μg/mL
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Proteus mirabilis: ≤0.008 μg/mL – 0.06 μg/mL
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Streptococcus pneumoniae: 0.12 μg/mL
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Staphylococcus aureus: >128 μg/mL (Resistant)
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Enterobacter spp.: >128 μg/mL (Resistant)
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 slowed but not 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.
Distribution
It has high concentrations in bile and urine. It can cross the placenta and its protein binding capacity is 65%.
Contraindications
Cefixime is contraindicated in patients with known sensitivity or allergies to cephalosporin class of antibiotics.
Adverse effects
Adverse drug reactions include diarrhea, dyspepsia, nausea and vomiting.
Drug interactions
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Alcohol – No major interaction has been observed between cefixime and alcohol.
History
It was sold under the trade name Suprax 125 in the United States until 2003, when it was taken off the market by drug manufacturer Wyeth after its patent expired. Lupin started selling Suprax in the United States in 2007,
Marketing
Cefixime is marketed under many worldwide; examples include Fixacef, Pancef, Caricef, Taxim o, Texit, Ofex, Ceftid, Cef-3, Denvar, 3-C, Cefim, Magnett, Oroken, Ofiken, Fix-A, and Zifi.
