What is Cefixime?
Cefixime, often known by the brand name Suprax, is a third-generation cephalosporin antibiotic prescribed to treat a wide range of bacterial infections. It is not effective against viral infections, such as the common cold or flu, and should only be used to treat infections proven or strongly suspected to be bacterial. This medication comes in various forms, including tablets, capsules, chewable tablets, and a liquid suspension, and is available only with a prescription.
The Mechanism of Action
Cefixime, like other cephalosporins, kills bacteria by interfering with the synthesis of their cell walls. It binds to specific proteins in the bacterial cell wall, which are essential for its formation, leading to the cell's death. A notable feature of cefixime is its resistance to certain enzymes produced by bacteria that can break down antibiotics, making it effective against some resistant strains.
Clinical Applications and Indications
Cefixime is prescribed for various bacterial infections in adults and children over six months. Its uses depend on the location of the infection:
- Respiratory Tract Infections: Including acute flare-ups of chronic bronchitis due to susceptible Streptococcus pneumoniae and Haemophilus influenzae, and throat infections (tonsillitis, pharyngitis) caused by Streptococcus pyogenes.
- Ear Infections (Otitis Media): Used for middle ear infections caused by susceptible Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes. The liquid form is often better absorbed by children with otitis media.
- Urinary Tract Infections (UTIs): Treats uncomplicated UTIs caused by susceptible Escherichia coli and Proteus mirabilis.
- Sexually Transmitted Diseases (STDs): Indicated for uncomplicated gonorrhea (cervical/urethral) caused by susceptible Neisseria gonorrhoeae. Cefixime can be an option if ceftriaxone is unavailable, but is less effective for throat gonorrhea.
- Off-label Uses: May be used in specific situations, such as for typhoid fever, salmonella, shigella, and sinusitis in patients allergic to penicillin. These uses require a doctor's evaluation.
Comparison of Cefixime and Amoxicillin
Here's a comparison between cefixime and amoxicillin, another common antibiotic:
| Feature | Cefixime | Amoxicillin |
|---|---|---|
| Drug Class | Third-generation cephalosporin | Aminopenicillin |
| Spectrum | Broader-spectrum against certain Gram-negative bacteria and resistant strains. | Narrower, effective against many common bacteria. |
| Activity | Less active against some Gram-positive bacteria than second-generation cephalosporins. | Strong activity against many Gram-positive bacteria. |
| Cost | Typically more expensive. | Often a lower cost generic. |
| Common Uses | UTIs, ear infections, bronchitis, gonorrhea. | Wide range, including strep throat, skin infections, some UTIs. |
| Side Effects | Common GI issues like diarrhea. | Generally well-tolerated, rash is common. |
Dosage Considerations
Dosage for cefixime varies based on the type and severity of the infection, the patient's age and weight, and kidney function. It is available in different strengths and formulations. A healthcare provider will determine the appropriate dose and duration of treatment.
Potential Side Effects and Precautions
The most common side effects are stomach issues like diarrhea, nausea, and abdominal pain. Less common, but serious, side effects include severe allergic reactions, kidney or liver problems, and Clostridioides difficile colitis (severe diarrhea).
Precautions:
- Allergies: Inform your doctor about any severe allergies to penicillin or cephalosporins due to a risk of cross-reaction.
- Medication Interactions: Cefixime can interact with drugs like warfarin (increasing bleeding risk) and may reduce the effectiveness of hormonal birth control, requiring alternative contraception.
- Kidney or Liver Disease: Dosage adjustments may be necessary for patients with these conditions.
- Complete the Course: Finish the entire prescription, even if symptoms improve, to fully treat the infection and prevent antibiotic resistance.
Conclusion
Cefixime is an effective third-generation cephalosporin antibiotic used to treat various bacterial infections in the respiratory tract, ears, urinary tract, and for uncomplicated gonorrhea. Its convenience and activity against certain resistant bacteria make it a valuable option. It's crucial to use cefixime only for bacterial infections as prescribed by a doctor and to complete the full treatment course. Patients should be aware of potential side effects and interactions.
For more detailed information, consult the MedlinePlus drug information page for Cefixime.
Cefixime: A Summary of Common Uses
- Uncomplicated Urinary Tract Infections (UTIs): Effective against susceptible strains of E. coli and P. mirabilis.
- Otitis Media (Ear Infections): Treats infections caused by H. influenzae, M. catarrhalis, and S. pyogenes.
- Pharyngitis and Tonsillitis: Used for bacterial infections of the throat and tonsils caused by S. pyogenes.
- Acute Exacerbations of Chronic Bronchitis: Fights infections caused by S. pneumoniae and H. influenzae.
- Uncomplicated Gonorrhea: A treatment option for infections of the cervix and urethra.
- Typhoid Fever and Shigella: Occasionally used for these infections, often based on specific clinical needs.
- Pneumonia: Has shown effectiveness in community-acquired pneumonia in adults.
Is Cefixime Effective Against All Bacteria?
No, cefixime is not effective against all bacteria. It is important to treat only infections caused by susceptible bacteria to prevent the development of drug-resistant bacteria. Some bacteria, like Pseudomonas and most staphylococci (including MRSA), are resistant to cefixime.
How is Cefixime Dosage Determined?
Cefixime dosage is determined by a healthcare provider based on factors such as the patient's age, weight, the specific type and severity of the infection being treated, and kidney function. It is important to follow the prescribed dosage and administration instructions carefully.
Can I Take Cefixime if I'm Allergic to Penicillin?
If you have a history of a severe penicillin allergy, you should inform your doctor. While cefixime is a different class of antibiotic (cephalosporin), there is a possibility of a cross-allergic reaction. Your doctor will determine if cefixime is a safe option.
What Should I Do if I Miss a Dose of Cefixime?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed one and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Does Cefixime Interact with Birth Control?
Yes, cefixime may decrease the effectiveness of hormonal contraceptives, such as birth control pills, patches, and rings. It is important to use a reliable non-hormonal form of contraception, like condoms, while taking cefixime.
Can Cefixime Be Used to Treat Colds or the Flu?
No, cefixime is an antibiotic and is not effective against viruses, which cause colds and the flu. Using antibiotics unnecessarily can lead to the development of antibiotic-resistant bacteria.
