Cefixime Explained

Verifiedfields:changed
Watchedfields:changed
Verifiedrevid:460023156
Tradename:Suprax, others
Dailymedid:Cefixime
Routes Of Administration:By mouth
Atc Prefix:J01
Atc Suffix:DD08
Legal Ca:Rx-only
Legal Ca Comment:[1] [2]
Legal Uk:POM
Legal Uk Comment:[3]
Legal Us:Rx-only
Legal Status:Rx-only
Bioavailability:30 to 50%
Protein Bound:Approximately 60%
Elimination Half-Life:Variable
Average 3 to 4 hours
Excretion:Kidney and biliary
Cas Number:79350-37-1
Pubchem:5362065
Drugbank:DB00671
Chemspiderid:4514923
Unii:XZ7BG04GJX
Kegg:D00258
Chebi:472657
Chembl:1541
Iupac Name:(6R,7R)-7--3-ethenyl-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
C:16
H:15
N:5
O:7
S:2
Smiles: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
Stdinchi: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
Stdinchikey:OKBVVJOGVLARMR-QSWIMTSFSA-N

Cefixime, sold under the brand name Suprax among others, is an antibiotic medication used to treat a number of bacterial infections. These infections include otitis media, strep throat, pneumonia, urinary tract infections, gonorrhea, and Lyme disease. For gonorrhea typically only one dose is required.[4] In the United States it is a second-line treatment to ceftriaxone for gonorrhea. It is taken by mouth.

Common side effects include diarrhea, abdominal pain, and nausea. Serious side effects may include allergic reactions and Clostridium difficile diarrhea. It is not recommended in people with a history of a severe penicillin allergy.[4] It appears to be relatively safe during pregnancy.[5] It is in the third-generation cephalosporin class of medications. It works by disrupting the bacteria's cell wall resulting in its death.[6]

Cefixime was patented in 1979 and approved for medical use in the United States in 1989.[6] [7] It is on the World Health Organization's List of Essential Medicines.[8] It is available as a generic medication in the United States.[9]

Medical uses

Cefixime treats infections of the:

It is also used to treat typhoid fever.[11] [12] [6]

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:[13]

Mechanism of action

The bactericidal action of Cefixime is due to the inhibition of cell wall synthesis. It binds to one of the 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.

AbsorptionOnly 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.

DistributionIt has high concentrations in bile and urine. It can cross the placenta and its protein binding capacity is 65%.

Contraindications

Cefixime is contraindicated in patients with known sensitivity or allergies to cephalosporin class of antibiotics.[14] [15] As Cefixime is a third generation cephalosporin, it is not contraindicated for patients with a true penicillin allergy.

Adverse effects

Adverse drug reactions include diarrhea, dyspepsia, nausea and vomiting. Hypersensitivity reactions like skin rashes, urticaria and Stevens–Johnson syndrome have been reported. There is no specific antidote for cefixime overdosage.

Drug interactions

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. Lupin started selling Suprax in the United States in 2007,[17] and it is available in different formulations and strengths.[18] [19] [20]

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.[21] [22] In India it is marketed as Zifi 200 and is commonly counterfeited.[23]

Notes and References

  1. Web site: Antibiotics . . 8 May 2018 . 13 April 2024.
  2. Web site: Regulatory Decision Summary for Auro-Cefixime . Drug and Health Products Portal . 9 November 2016 . 13 April 2024.
  3. Web site: Suprax 200 mg Tablets - Summary of Product Characteristics (SmPC) . (emc) . 20 August 2019 . 23 April 2020 . 22 September 2020 . https://web.archive.org/web/20200922195438/https://www.medicines.org.uk/emc/product/5534/smpc . dead .
  4. Book: WHO Model Formulary 2008 . 2009 . 9789241547659 . ((World Health Organization)) . Stuart MC, Kouimtzi M, Hill SR . 10665/44053 . World Health Organization . 107 . World Health Organization . free .
  5. Web site: Cefixime (Suprax) Use During Pregnancy . Drugs.com . 29 March 2019 . 24 December 2019.
  6. Web site: Cefixime. The American Society of Health—System Pharmacists. 8 December 2016. live. https://web.archive.org/web/20161127220806/https://www.drugs.com/monograph/cefixime.html. 27 November 2016.
  7. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 495 .
  8. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free .
  9. Web site: Generic Suprax Availability . Drugs.com . 23 April 2020.
  10. Book: Kucers' the use of antibiotics : a clinical review of antibacterial, antifungal, antiparasitic and antiviral drugs. 2017. Grayson ML . 978-1-315-15211-0. Seventh. Boca Raton. 1011357224.
  11. Matsumoto Y, Ikemoto A, Wakai Y, Ikeda F, Tawara S, Matsumoto K . Mechanism of therapeutic effectiveness of cefixime against typhoid fever . Antimicrobial Agents and Chemotherapy . 45 . 9 . 2450–2454 . September 2001 . 11502513 . 90676 . 10.1128/aac.45.9.2450-2454.2001 .
  12. Bhutta ZA, Khan IA, Molla AM . Therapy of multidrug-resistant typhoid fever with oral cefixime vs. intravenous ceftriaxone . The Pediatric Infectious Disease Journal . 13 . 11 . 990–994 . November 1994 . 7845753 . 10.1097/00006454-199411000-00010 .
  13. Web site: Cefixime trihydrate Susceptibility and Minimum Inhibitory Concentration (MIC) Data . www.toku-e.com .
  14. Web site: Suprax- cefixime tablet Suprax- cefixime capsule Suprax- cefixime tablet, chewable Suprax- cefixime powder, for suspension . DailyMed . 26 November 2019 . 23 April 2020.
  15. Web site: Suprax- cefixime powder, for suspension . DailyMed . 2 January 2020 . 23 April 2020.
  16. Web site: Medicines information links. NHS Choices . UK National Health Service . 22 August 2016. live. https://web.archive.org/web/20150711002908/http://www.nhs.uk/conditions/gonorrhoea/pages/MedicineOverview.aspx?condition=Bacterial%20infections&medicine=Cefixime&preparationCefixime%20100mg%2F5ml%20oral%20suspension . 11 July 2015.
  17. Web site: Suprax: FDA-Approved Drugs . U.S. Food and Drug Administration (FDA) . 23 April 2020.
  18. Web site: Suprax: FDA-Approved Drugs . U.S. Food and Drug Administration (FDA) . 23 April 2020.
  19. Web site: Suprax: FDA-Approved Drugs . U.S. Food and Drug Administration (FDA) . 23 April 2020.
  20. Web site: Suprax: FDA-Approved Drugs . U.S. Food and Drug Administration (FDA) . 23 April 2020.
  21. Web site: Cefixime—Drugs.com. www.drugs.com. 10 December 2016. live. https://web.archive.org/web/20160530044200/http://www.drugs.com/international/cefixime.html. 30 May 2016.
  22. Web site: FDC—Products—Formulations . fdcindia.com . 2 May 2018.
  23. News: Perur S . Fake drugs: the global industry putting your life at risk . 13 December 2018 . Mosaic . 30 October 2018.