Cefixime

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Cefixime
Clinical data
Trade namesSuprax, others[1]
AHFS/Drugs.comMonograph
MedlinePlusa690007
License data
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability30 to 50%[5]
Protein bindingApproximately 60%
Elimination half-lifeVariable
Average 3 to 4 hours
ExcretionKidney and biliary
Identifiers
  • (6R,7R)-7-{[2-(2-Amino-1,3-thiazol-4-yl)-2-(carboxymethoxyimino)acetyl]amino}-3-ethenyl-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
JSmol)
  • O=C2N1/C(=C(/C=C)CS[C@@H]1[C@@H]2NC(=O)C(=N\OCC(=O)O)/c3nc(sc3)N)C(=O)O
  • InChI=1S/C16H15N5O7S2/c1-2-6-4-29-14-10(13(25)21(14)11(6)15(26)27)19-12(24)9(20-28-3-8(22)23)7-5-30-16(17)18-7/h2,5,10,14H,1,3-4H2,(H2,17,18)(H,19,24)(H,22,23)(H,26,27)/b20-9-/t10-,14-/m1/s1 checkY
  • Key:OKBVVJOGVLARMR-QSWIMTSFSA-N checkY
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Cefixime, sold under the brand name Suprax among others, is an

urinary tract infections, gonorrhea, and Lyme disease.[5] For gonorrhea typically only one dose is required.[6] In the United States it is a second-line treatment to ceftriaxone for gonorrhea.[5] It is taken by mouth.[5]

Common side effects include

penicillin allergy.[6] It appears to be relatively safe during pregnancy.[7] It is in the third-generation cephalosporin class of medications.[5] It works by disrupting the bacteria's cell wall resulting in its death.[5]

Cefixime was patented in 1979 and approved for medical use in the United States in 1989.

generic medication in the United States.[10]

Medical uses

Cefixime treats infections of the:

It is also used to treat typhoid fever.[13][14][5]

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:[15]

  • 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
  • Streptococcus pneumoniae: 0.12 μg/mL[12]
  • Staphylococcus aureus: >128 μg/mL (Resistant)[12]
  • Enterobacter spp.: >128 μg/mL (Resistant) [12]

Mechanism of action

The bactericidal action of Cefixime is due to the inhibition of cell wall synthesis.[

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.[medical citation needed
]

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.[11]

Distribution It has high concentrations in bile and urine. It can cross the placenta and its protein binding capacity is 65%.[medical citation needed]

Contraindications

Cefixime is contraindicated in patients with known sensitivity or allergies to

antibiotics.[11][16]
As Cefixime is a third generation cephalosporin, it is not contraindicated for patients with a true penicillin allergy.

Adverse effects

Adverse drug reactions include

urticaria and Stevens–Johnson syndrome have been reported.[medical citation needed] There is no specific antidote for cefixime overdosage.[medical citation needed
]

Drug interactions

  • Alcohol – No major interaction has been observed between cefixime and alcohol.
    better source needed
    ]

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.[citation needed] Lupin started selling Suprax in the United States in 2007,[18] and it is available in different formulations and strengths.[18][19][20][21]

Marketing

Cefixime is marketed under many

brand names worldwide; examples include Pancef, Caricef, Taxim o, Texit, Ofex, Ceftid, Cef-3, Denvar, 3-C, Cefim, Magnett, Oroken, Ofiken, Fix-A, and Zifi.[1][22] In India it is marketed as Zifi 200 and is commonly counterfeited.[23]

References

  1. ^ a b "Cefixime—Drugs.com". www.drugs.com. Archived from the original on 30 May 2016. Retrieved 10 December 2016.
  2. ^ "Antibiotics". Health Canada. 8 May 2018. Retrieved 13 April 2024.
  3. ^ "Regulatory Decision Summary for Auro-Cefixime". Drug and Health Products Portal. 9 November 2016. Retrieved 13 April 2024.
  4. ^ a b c d e f "Suprax 200 mg Tablets - Summary of Product Characteristics (SmPC)". (emc). 20 August 2019. Archived from the original on 22 September 2020. Retrieved 23 April 2020.
  5. ^ a b c d e f g h i j k l m n o p q "Cefixime". The American Society of Health—System Pharmacists. Archived from the original on 27 November 2016. Retrieved 8 December 2016.
  6. ^
    ISBN 9789241547659
    .
  7. ^ "Cefixime (Suprax) Use During Pregnancy". Drugs.com. 29 March 2019. Retrieved 24 December 2019.
  8. ISBN 9783527607495
    .
  9. hdl:10665/325771
    . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  10. ^ "Generic Suprax Availability". Drugs.com. Retrieved 23 April 2020.
  11. ^ a b c d e f g "Suprax- cefixime tablet Suprax- cefixime capsule Suprax- cefixime tablet, chewable Suprax- cefixime powder, for suspension". DailyMed. 26 November 2019. Retrieved 23 April 2020.
  12. ^
    OCLC 1011357224.{{cite book}}: CS1 maint: location missing publisher (link
    )
  13. PMID 11502513
    .
  14. PMID 7845753
    .
  15. ^ "Cefixime trihydrate Susceptibility and Minimum Inhibitory Concentration (MIC) Data" (PDF). www.toku-e.com.
  16. ^ "Suprax- cefixime powder, for suspension". DailyMed. 2 January 2020. Retrieved 23 April 2020.
  17. ^ "Medicines information links". NHS Choices. UK National Health Service. Archived from the original on 11 July 2015. Retrieved 22 August 2016.
  18. ^ a b "Suprax: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 23 April 2020.
  19. ^ "Suprax: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 23 April 2020.
  20. ^ "Suprax: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 23 April 2020.
  21. ^ "Suprax: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 23 April 2020.
  22. ^ "FDC—Products—Formulations". fdcindia.com. Retrieved 2 May 2018.
  23. ^ Perur S (30 October 2018). "Fake drugs: the global industry putting your life at risk". Mosaic. Retrieved 13 December 2018.
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