Indications

Afix is an oral cephalosporin antibiotic used to treat acute infections caused by susceptible microorganisms. It is effective against a wide range of bacteria and is indicated for:

• Upper Respiratory Tract Infections (URTIs): Including otitis media and other URTIs where the causative organism is suspected to be resistant to other common antibiotics.
• Lower Respiratory Tract Infections: Such as bronchitis.
• Urinary Tract Infections: Such as cystitis, cystourethritis, and pyelonephritis. Afix is highly stable against beta-lactamase enzymes, making it effective against many resistant organisms.

Pharmacology

Cefixime, a third-generation cephalosporin antibiotic, is a bactericidal agent that works by interfering with the synthesis of the bacterial cell wall. It is effective against a broad spectrum of gram-positive and gram-negative bacteria. Its stability in the presence of beta-lactamase enzymes allows it to be effective against organisms that are resistant to penicillins and some other cephalosporins. The drug is absorbed about 40-50% after oral administration, with or without food.

Dosage & Administration

• General: The usual treatment course is 7 days but may be extended to 14 days if needed.
• Adults and children over 10 years: The recommended dose is 200-400 mg daily, either as a single dose or in two divided doses, depending on the severity of the infection.
• Elderly: The same dose as adults can be given, but renal function should be assessed, and the dose adjusted in cases of severe renal impairment.
• Children: The recommended dose is 8 mg/kg/day, given as a single dose or in two divided doses. For typhoid, the dose is 5 mg/kg twice daily for 10-14 days.
• Children weighing over 50 kg or older than 10 years: Should be treated with the adult dose.
• Children under 6 months: The safety and efficacy of Afix have not been established.
• Renal Impairment: No dosage adjustment is needed for patients with a creatinine clearance of 20 ml/min or more. For those with a creatinine clearance of less than 20 ml/min, the dose should not exceed 200 mg once daily.

Interaction

Similar to other cephalosporins, Afix may increase prothrombin times in some patients. Caution should be used in patients receiving anticoagulant therapy.

Contraindications

Afix is contraindicated in patients with a known hypersensitivity to cephalosporin antibiotics.

Side Effects

Afix is generally well tolerated, and most side effects are mild and self-limiting.

• Gastrointestinal: The most common side effects are diarrhea and changes in stool. Other less frequent effects include nausea, abdominal pain, indigestion, vomiting, and flatulence. Pseudomembranous colitis has also been reported.
• Central Nervous System: Headache and dizziness.
• Hypersensitivity Reactions: Rash, itching, hives, drug fever, and joint pain have been observed.
• Hematological: Rare and reversible reactions such as low platelet count (thrombocytopenia), low white blood cell count (leukopenia), and high eosinophil count (eosinophilia) have been reported.
• Miscellaneous: Genital itching and vaginitis.

Pregnancy & Lactation

There are no adequate and well-controlled studies of Afix in pregnant women. It should be used during pregnancy only if clearly necessary. It is not known whether cefixime is excreted in human milk, so caution should be exercised when administering it to a nursing woman.

Precautions & Warnings

• Hypersensitivity: Afix should be used with caution in patients with a history of hypersensitivity to other drugs, especially penicillins, due to a risk of cross-allergenicity.
• Allergic Reactions: If an allergic reaction occurs, the drug should be discontinued immediately.
• Renal Function: Administer with caution to patients with significantly impaired renal function.
• Clostridium Difficile: Treatment with broad-spectrum antibiotics can alter the normal flora of the colon and lead to overgrowth of Clostridium difficile, which can cause antibiotic-associated diarrhea.

Overdose Effects

In case of an overdose, gastric lavage may be indicated. There is no specific antidote. Afix is not effectively removed from the body by hemodialysis or peritoneal dialysis.

Storage Conditions

Keep at a temperature below 30°C, protected from light and moisture. Keep out of the reach of children.