Cefixime Tablets USP 400 mg is an orally active cephalosporin antibiotic indicated for the treatment of the following infections when caused by susceptible organisms:
- Acute exacerbations of chronic bronchitis
- Community-acquired Pneumonia
- Uncomplicated lower urinary tract infections
- Uncomplicated pyelonephritis
In the treatment of:
- Otitis media
The use of cefixime should be reserved for infections in which the causative organism is known or suspected to be resistant to other commonly used antibacterial agents or when treatment failure may carry significant risk.
Consideration should be given to official guidance on the appropriate use of antibacterial agents.
Adults and adolescents aged 12 years and above
The recommended dose is 400 mg daily taken as a single dose or 2 x 200mg daily dose.
The usual course of treatment is 7 days. This may be continued for up to 14 days if required.
Elderly patients may be given the same dose as recommended for adults. Renal function should be assessed and dosage should be adjusted in severe renal impairment.
Diarrhoea, Diarrhoea has been more commonly associated with higher doses. Some cases of moderate to severe diarrhoea have been reported; this has occasionally warranted cessation of therapy. Cefixime should be discontinued if marked diarrhoea occurs.
Beta-lactams, including cefixime, predispose the patient to encephalopathy risk (which may include convulsions, confusion, impairment of consciousness, movement disorders), particularly in case of overdose or renal impairment.
Severe cutaneous adverse reactions
Severe cutaneous adverse reactions such as toxic epidermal necrolysis, Stevens-Johnson syndrome and drug rash with eosinophilia and systemic symptoms (DRESS) have been reported in some patients on cefixime. When severe cutaneous adverse reactions occur, cefixime should be discontinued and appropriate therapy and/or measures should be taken.
Cefixime should be given with caution to patients who have shown hypersensitivity to other drugs.
Hypersensitivity to penicillins
Cephalosporins should be given with caution to patients with a history of mild to moderate hypersensitivity to penicillin as there is some evidence of partial cross-allergenicity between the penicillins and cephalosporins.
Patients have had severe reactions (including anaphylaxis) to both classes of drugs. Special care is indicated in patients who have experienced any allergic reaction to penicillins or any other beta-lactam antibiotics as cross-reactions may occur.
If severe hypersensitivity reactions or anaphylactic reactions occur after administration of cefixime, the use of cefixime should be discontinued immediately and appropriate emergency measures should be initiated.
Drug- induced haemolytic anaemia, including severe cases with a fatal outcome, has been described for cephalosporins (as a class). The recurrence of haemolytic anaemia after re-administration of cephalosporins in a patient with a history of cephalosporin (including cefixime) –associated haemolytic anaemia has also been reported.
Acute renal failure
As with other cephalosporins, cefixime may cause acute renal failure including tubulointerstitial nephritis as an underlying pathological condition. When acute renal failure occurs, cefixime should be discontinued and appropriate therapy and/or measures should be taken.
Cefixime should be administered with caution in patients with creatinine clearance < 20 ml / min. There are insufficient data regarding use of cefixime in the paediatric and adolescent age group in the presence of renal insufficiency. Therefore, the use of cefixime in these patient-groups is not recommended.
Renal function is to be monitored under a combination therapy with cefixime preparations and aminoglycoside antibiotics, polymyxin B, colistin or high-dose loop diuretics (e.g. furosemide) because of the probability of additional renal impairment. This applies particularly for patients with already restricted renal function.
Treatment with broad spectrum antibiotics alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is a primary cause of antibiotic-associated diarrhoea. Pseudomembranous colitis is associated with the use of broad-spectrum antibiotics (including macrolides, semi-synthetic penicillins, lincosamides and cephalosporins); it is therefore important to consider its diagnosis in patients who develop diarrhoea in association with the use of antibiotics. Symptoms of pseudomembranous colitis may occur during or after antibiotic treatment.
The use of cefixime should be discontinued.
Management of pseudomembranous colitis should include sigmoidoscopy, appropriate bacteriologic studies, fluids, electrolytes and protein supplementation. If the colitis does not improve after the drug has been discontinued, or if the symptoms are severe, oral vancomycin is the drug of choice for antibiotic-associated pseudomembranous colitis produced by C. difficile. Other causes of colitis should be excluded. The use of medicinal products inhibiting the intestinal peristalsis is contraindicated.
Safety of cefixime in premature or newborn infants has not been established.
Store below 30°C and protect from light.
Keep the medicine out of reach of children.
10 × 10 Alu/Alu Blister.
Ceficonex-400 tablets are available in an Alu/Alu blister of 10 tablets. Such 10 blisters in a unit carton with pack insert.