Cefixime | apollo +991 46 950 950

Cefixime | apollo +991 46 950 950

Cefixime

CAS Number : 79350-37-1

Molecular Weight : 453.45 g/mol Molecular Formula : C16H15N5O7S2

Systematic (IUPAC) : (6R,7R)-7-[(2Z)-2-(2-amino-1,3-thiazol-4-yl)-2-

[(carboxymethoxy)imino]acetamido]-3-ethenyl-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid

Type : small molecule

Description : Cefixime, an antibiotic, is a third-generation cephalosporin like ceftriaxone and

cefotaxime. Cefixime is highly stable in the presence of

beta-lactamase enzymes. As a result, many organisms resistant to penicillins and some cephalosporins due to the presence of beta-lactamases, may be susceptible to cefixime. The antibacterial effect of cefixime results from inhibition of mucopeptide synthesis in the bacterial cell

wall.

Categories : Anti-Bacterial Agents

Cephalosporins

Pharmacology

Indication : For use in the treatment of the following infections when caused by susceptible strains of the

designated microorganisms: (1) uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis, (2) otitis media caused byHaemophilus influenzae (beta-lactamase positive and negative

strains), Moraxella catarrhalis (most of which are beta-lactamase positive), and S. pyogenes, (3) pharyngitis and tonsillitis caused by S. pyogenes, (4) acute bronchitis

and acute exacerbations of chronic bronchitis caused by Streptococcus pneumoniae and Haemophilus influenzae (beta-lactamase positive and negative strains), and (5) uncomplicated gonorrhea (cervical/urethral) caused by

Neisseria gonorrhoeae (penicillinase- and non-penicillinase-producing strains).

Pharmacodynamics : Cefixime, an antibiotic, is a third-generation cephalosporin like ceftriaxone and

cefotaxime. Cefixime is highly stable in the presence of beta-lactamase enzymes. As a result, many organisms resistant to penicillins and some cephalosporins due to the presence of beta-lactamases, may be susceptible to

cefixime. The antibacterial effect of cefixime results from inhibition of mucopeptide synthesis in the bacterial cell

wall.

Mechanism of action : Like all beta-lactam antibiotics, cefixime binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, causing the inhibition of the third and last stage of

bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as

autolysins; it is possible that cefixime interferes with an autolysin inhibitor.

Absorption : About 40%-50% absorbed orally whether administered with or without food, however, time to maximal absorption is increased approximately 0.8

hours when administered with food.

Protein binding : 65% (concentration independent)

Metabolism : Hepatic. Approximately 50% of the absorbed dose is excreted unchanged in the urine in 24

hours.

Half life : 3-4 hours (may range up to 9 hours). In severe renal impairment (5 to 20 mL/min creatinine clearance), the half-life increased to an average of 11.5

hours.

Toxicity : Symptoms of overdose include blood in the urine, diarrhea, nausea, upper abdominal pain, and

vomiting.

Affected organisms : Enteric bacteria and other eubacteria

Drug Class and Mechanisms

Cefixime is a semi-synthetic (partially man-made), oral antibiotic in the cephalosporin family of antibiotics. The

cephalosporin family includes cephalexin (Keflex), cefaclor (Ceclor),cefuroxime (Zinacef), cefpodoxime (Vantin), cefprozil (Cefzil), and many injectable forms. Like other cephalosporins, cefixime stops bacteria from multiplying by preventing bacteria from forming the walls that surround them. The walls are necessary to

protect bacteria from their environment and to keep the contents of the bacterial cell together; bacteria cannot survive without a cell wall. Cefixime is active against a very wide spectrum of bacteria such as Staphylococcus aureus, Streptococcus pneumoniae,Streptococcus pyogenes (the cause of strep throat), Hemophilus influenzae, Moraxella catarrhalis, E. coli, Klebsiella, Proteus mirabilis, Salmonella,Shigella, and Neisseria

gonorrhoeae. The FDA approved cefixime in April 1989.

Dosing

The recommended adult dose is 400 mg once daily.

Drug Interactions

Probenecid (Benemid) may increase the blood concentration of cefixime by decreasing removal of cefixime by the kidney. This interaction sometimes is

used to enhance the effect of cephalosporins. Combining cefixime with aminoglycosides [for example,

tobramycin(Tobradex) produces additive bacterial killing effects but also may increase the risk of harmful

effects to the kidney. Cefixime is a cephalosporin antibiotic used to treat infections caused by bacteria such as pneumonia;

bronchitis; gonorrhea; and ear, lung, throat, and urinary

tract infections. Antibiotics will not work for colds, flu, or other viral infections.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Cefixime comes as a tablet and liquid to take by mouth. It is usually taken once a day or every 12 hours (twice a day) for 5-14 days. Gonorrhea may be treated in 1-10 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cefixime exactly as directed. Do not take more or less of it or take it more

often than prescribed by your doctor. Shake the liquid well before each use to mix the

medication evenly. The tablets should be swallowed whole and taken with a

full glass of water. Continue to take cefixime even if you feel well. Do not stop taking cefixime without talking to your doctor.

What special precautions should I follow?

Before taking cefixime, tell your doctor and pharmacist if you are allergic to cefixime or other any cephalosporin antibiotic such as cefaclor (Ceclor) or cephalexin (Keflex), penicillin, or

any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antibiotics, anticoagulants ('blood thinners') such

as warfarin (Coumadin), aspirin, carbamazepine (Tegretol), probenecid (Benemid), and vitamins.

tell your doctor if you have or have ever had kidney or liver disease, colitis, or stomach problems.

tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant

while taking cefixime, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking cefixime.

What special dietary instructions should I follow?

Cefixime may cause an upset stomach. Take cefixime with food or milk.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Cefixime may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

upset stomach

diarrhea

vomiting

mild skin rash

headache

If you experience any of the following symptoms, call your doctor immediately:

severe skin rash

itching

hives

difficulty breathing or swallowing

wheezing

vaginal infection

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any

medication that is outdated or no longer needed. Keep liquid medicine in the refrigerator, closed tightly, and

throw away any unused medication after 14 days. Do not freeze. Talk to your pharmacist about the proper

disposal of your medication.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to

check your response to cefixime. If you are diabetic, use Clinistix or TesTape (not

Clinitest) to test your urine for sugar while taking this drug.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the cefixime, call

your doctor. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You

should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of

emergencies.

Pharmacodynamics

Pharmacokinetics

Cefixime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall

assembly resulting in bacterial cell death.

Absorption

Only 40-50% is absorbed from the GI tract (oral); rate may be decreased if taken with food. Greater absorption

from oral suspension than tablets.

Distribution

Bile, urine (high concentrations); crosses the placenta.

Protein-binding : 65%.

Excretion

20% of an oral dose excreted via urine unchanged; 60% nonrenal elimination; some is excreted via the faeces from the bile. Substantially removed by dialysis.

General Advice

Administer prescribed dose without regard to meals, but administer with food if GI upset occurs.

Shake suspension well before measuring dose. Measure and administer prescribed dose of suspension using dosing syringe, dosing spoon, or medicine cup.

Storage/Stability

Store powder at 68° to 77°F. After reconstitution, store at room temperature or under refrigeration for up to 14 days. Keep tightly closed. Shake well before using.

Discard unused portion after 14 days.

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