Cefixime

Cefixime is an active substance for the treatment of bacterial infections. It belongs to the group of cephalosporins, a class of antibiotics. Cephalosporins are broad-spectrum antibiotics and are part of the ß-lactam antibiotics. Cefixime is mainly used to treat respiratory diseases, urinary tract infections and gonorrhea. Like the other representatives of the cephalosporins, cefixime has the functional group of a cephem. It is a white powder that is slightly soluble in water. The active ingredient is available in several different forms, as tablets, film-coated tablets, dry juice or granules. It occurs naturally in the mold Cephalosporium acremonium.

Cefixime works by killing gram-positive and gram-negative bacteria. Due to the beta-lactam ring, which cephalosporins possess, cefixime can bind to the penicillin-binding proteins (PBS), which disrupts cell wall synthesis. This inhibits the production of peptidoglycan, which is a central building block in the cell wall of bacteria. This inhibition causes the cell to lyse, which means that it dissolves and dies. Cefixime is particularly effective in rapidly dividing cells.

The bioavailability, i.e. the percentage of the active ingredient available in the blood, is 40-50%. The half-life, i.e. the time the body needs to excrete half of the active substance, is 3-4 hours. The maximum plasma concentration (Cmax), i.e. the maximum concentration of the active substance in the blood plasma (liquid cell-free part of the blood) reaches its peak of 3.25 mg/L after 4 hours. Cefixime is excreted in the urine.

Always take Cefixim exactly as described in the package leaflet or as advised by your doctor.

Adults:

The usual recommended dose is 400 mg daily divided into one dose or 200 mg daily divided into two doses.

Children & adolescents under 12 years of age:

Juices are available for children under 12 to drink .

The following side effects may occur:

Frequent:

• Diarrhea

Occasional:

• Headache
• Abdominal pain
• Indigestion
• Nausea
• vomiting
• Increase in liver enzymes
• Skin rashes

Rarely:

• Superinfections with long-term and repeated use
• Overproduction of eosinophil granulocytes
• flushing
• Cardiac arrhythmia
• Breathing difficulties
• Drop in blood pressure
• bronchiospasm
• angioneurotic edema
• dizziness
• loss of appetite
• flatulence
• itching
• Inflammation of the mucous membranes
• Increase in urea concentration
• Drug fever

Very rare:

• Blood count changes
• allergic shock
• arthralgia
• joint inflammation
• joint swelling
• myalgia
• hives
• hyperactivity
• Inflammation of the colon
• inflammation of the liver
• jaundice
• severe skin rashes
• Stevens-Johnson syndrome
• toxic epidermal necrolysis
• increase in creatinine concentration
• interstitial nephritis

Frequency unknown:

• Granulocytopenia
• encephalopathy
• Increased bilirubin in the blood
• DRESS syndrome
• acute renal failure

Interactions may occur if the following medicines are taken at the same time:

• Aminoglycoside antibiotics
• colistin
• polymyxin
• viomycin
• etacrynic acid
• furosemide
• nifedipine
• certain coumarin-type blood thinners
• aluminum hydroxide
• magnesium hydroxide

Cefixime must NOT be taken in the following cases:

• in case of allergy to cefixime

An oral preparation (juice) should be used for children under 12 years of age.

During pregnancy, cefixime should only be taken after careful risk-benefit assessment by a doctor. No adverse effects were observed in animal studies or in studies with over 100 pregnancies evaluated. However, as cefixime is placental, it should only be used very carefully and specifically against certain pathogens during pregnancy. Cefuroxime can be taken as an alternative.

During breastfeeding, cefixime should also only be taken after a careful risk-benefit assessment by a doctor. In experience reports, most breastfed children had no symptoms. In individual cases, however, diarrhea has been reported in infants.

Cephalosporins were first isolated from the mold Cephalosporium acremonium in the form of cephalosporin-C in 1945. The chemical structure was elucidated in 1953.