Indications

Duracef (Cefixime) is a third-generation cephalosporin antibiotic used for treating a wide range of acute infections caused by susceptible bacteria. It is highly stable in the presence of beta-lactamase enzymes, making it effective against many resistant organisms.

• Upper Respiratory Tract Infections (URTI): Including otitis media.
• Lower Respiratory Tract Infections (LRTI): Such as bronchitis.
• Urinary Tract Infections (UTI): Including cystitis, cystourethritis, and pyelonephritis.

Pharmacology

Cefixime is a bactericidal antibiotic 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. About 40-50% of an oral dose is absorbed, and absorption is not significantly affected by food.

Dosage & Administration

• Adults and Children over 10 years: 200-400 mg daily, given as a single dose or in two divided doses.
• Children: 8 mg/kg/day, as a single dose or in two divided doses.
  • Suggested doses for suspension:
    • 6 months to 1 year: 3.75 ml daily.
    • 1-4 years: 5 ml daily.
    • 5-10 years: 10 ml daily.
• Renal Impairment: Dosage should be adjusted for patients with a creatinine clearance less than 20 ml/min. The dose should not exceed 200 mg once daily.
• Duration of Treatment: The usual course is 7 days, which may be extended up to 14 days.

Interaction

• Anticoagulants: Use with caution in patients receiving anticoagulant therapy, as Cefixime may increase prothrombin times.

Contraindications

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

Side Effects

Most side effects are mild and temporary. Common side effects include gastrointestinal disturbances such as diarrhea, nausea, and abdominal pain. Less common side effects include headache, dizziness, and allergic reactions (rash, itching, fever). Hematological changes and transient changes in liver and renal function tests have been reported.

Pregnancy & Lactation

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

Precautions & Warnings

• Use with caution in patients with a history of hypersensitivity to other drugs, particularly penicillin, due to the risk of cross-allergenicity.
• Use with caution in patients with markedly impaired renal function.
• The use of broad-spectrum antibiotics can alter the normal flora of the colon, which may lead to the overgrowth of Clostridium difficile, causing antibiotic-associated diarrhea.

Overdose Effects

In case of overdose, gastric lavage may be indicated. Duracef is not significantly removed by hemodialysis or peritoneal dialysis.

Storage Conditions

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