cefixime: clinical use

Prescribing considerations

• Confirm that the infection and likely pathogen fit the licensed spectrum and local susceptibility context.
• Assess renal function, particularly in older people or known renal impairment.
• Clarify cephalosporin allergy and the nature of any previous penicillin or other beta-lactam reaction.
• Use caution with previous colitis, central nervous system disease or concurrent anticoagulation.
• The selected tablet formulation is not recommended for children under 10 years; safety has not been established in premature or newborn infants.

Contraindications and cautions

• Hypersensitivity to cefixime or another cephalosporin
• Hypersensitivity to any product excipient

Monitoring

• Renal function where impairment is present or suspected
• New confusion, reduced consciousness, movement disorder or convulsions, particularly with renal impairment
• Severe skin reactions and mucosal lesions
• Marked or persistent diarrhoea during or after treatment
• Clotting parameters and bleeding in patients receiving coumarin anticoagulants
• Blood count and hepatic or renal laboratory results when clinically indicated

Clinical pharmacology

Cefixime is an orally active, bactericidal third-generation cephalosporin. Food does not significantly alter absorption. It is predominantly eliminated unchanged in urine, and exposure increases as renal function declines.

Formulation and product differences

• The selected UK product is an off-white, film-coated oral tablet engraved “ORO”.
• The tablet should be swallowed whole with water; no alternative formulation is represented by the selected document.

Tablet

Route: Oral

Strengths: 200 mg