Adult Dosing

Infections, bacterial

• 400 mg PO daily

Uncomplicated gonoccocal infections

• 400 mg PO x 1

Disseminated gonococcal infections

• 400 mg PO bid x 6 days
• Note: use after IV tx

Pediatric Dosing

Infections, bacterial

Child (6 months-11 yrs, < 50 kgs)

• 8 mg/kg/day PO divided daily-bid
• Max: 400 mg/day

Child (> 12 yrs, > 50 kgs)

• 400 mg PO daily

Uncomplicated gonoccocal infections

• 400 mg PO x 1

• Use suspension for otitis media
• Tablets and suspension are not bioequivalent

[Outline]

• Adult Dosing
• Pediatric Dosing

• Cefixime is indicated for the following infections caused by susceptible strains of the designated microorganisms
• Uncomplicated urinary tract infections
• Uncomplicated gonorrhea
• Respiratory tract infections
• Otitis media

• Hypersensitivity to cephalosporins or other beta lactam compounds
• Severe hypersensitivity to penicillins

• N/A

Renal Dose Adjustment (Based on CrCl)

• 21-60 mL/min: 75% of usual dose
• < 20 mL/min: 50% of usual dose
• HD: 75% of usual dose
• CAPD: 50% of usual dose

Hepatic Dose Adjustment

• No dose adjustments

• Before starting therapy with cefixime, carefully inquire if patients have had previous hypersensitivity to cephalosporins, penicillins or other b-lactams. Extreme caution must be exercised as cross reactivity among beta-lactam antibiotics is clearly documented and may occur in up to 10% of patients
• Cefixime should be used to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. Prescribing in the absence of a proven or strongly suspected bacterial infection increases the risk of the development of drug-resistant bacteria
• Anaphylactic/anaphylactoid reactionns, including shock and fatalities, have been reported with the use of cefixime
• The dose of cefixime should be adjusted in patients with renal impairment as well as in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD)
• Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of cefipime
• Prolonged use may result in the overgrowth of nonsusceptible organisms

Cautions: Use cautiously in

• Renal impairment
• Concurrent nephrotoxic agents
• Hypersensitivity to penicillins
• Hx of GI disease
• Hx of antibiotic associated colitis
• Seizure disorder

Pregnancy Category:B

Breastfeeding: Safety unknown. No information available for the use of cefixime during breastfeeding. However, cephalosporins are generally not expected to cause adverse effects in breastfed infants. This information is based upon data from LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 17 May 2010). Manufacturer advises caution

• GI: Pseudomembranous colitis, diarrhea, abdominal pain, dyspepsia, flatulence, nausea, vomiting, hepatic dysfunction (transient elevations in SGPT, SGOT, alkaline phosphatase, hepatitis, jaundice)
• CNS: Headache, dizziness, seizures
• DERM: Rash, urticaria, Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis; serum sickness-like reactions
• GU/Renal: Genital pruritus, vaginitis, acute renal failure, toxic nephropathy
• LAB TESTS: Hyperbilirubinemia, elevated BUN/creatinine
• HEMA: Transient thrombocytopenia, leukopenia, neutropenia, eosinophilia, aplastic anemia, hemolytic anemia, prolongation in prothrombin time
• MISC: Anaphylactic/anaphylactoid reactions (including shock and fatalities), super-infection, Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis, serum sickness-like reactions, hemorrhage

• Bactericidal; binds to bacterial cell wall membrane; inhibits cell wall mucopeptide synthesis
• Not metabolized
• Excreted in urine (50% unchanged) and bile (> 10%)
• Half-life: 3-4 hrs, increased in renal impairment

US Trade Name(s)

• Suprax

US Availability

cefixime (generic)

• CAPS: 400 mg

Suprax

• TABS: 400 mg
• CAPS: 400 mg
• CHEW TABS: 100, 150, 200 mg
• SUSP: 100 mg/5 mL (50, 75, 100 mL)
• SUSP: 200 mg/5 mL
• SUSP: 500 mg/5 mL

Canadian Trade Name(s)

• Suprax

Canadian Availability

Suprax

• TABS: 400 mg
• SUSP: 100 mg/5 mL (50 mL)

UK Trade Name(s)

• Suprax

UK Availability

Suprax

• TABS: 200 mg
• SUSP: 100 mg/5 mL (50, 100 mL)

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Antimicrobials

Antibiotics

Cephalosporins; Third Generation

Infectious Disease

Antibiotics

Cephalosporins; Third Generation

Pricing data from www.DrugStore.com in U.S.A.

• Suprax 100 MG/5ML SUSR [Bottle] (LUPIN PHARMACEUTICALS)
  100 5ml = $293.93
  300 5ml = $850.38

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.