Indications

Fix-A (Cefixime) is an orally active cephalosporin antibiotic used to treat acute infections caused by susceptible microorganisms. It is indicated for:

• Upper Respiratory Tract Infections (URTI): Including otitis media and other URTI where the causative organism is known or suspected to be resistant to other common antibiotics.
• Lower Respiratory Tract Infections: Such as bronchitis.
• Urinary Tract Infections: Including cystitis, cystourethritis, and pyelonephritis. It is effective against a wide range of bacteria, including Streptococcus pneumoniae, Haemophilus influenzae, and E. coli.

Pharmacology

Cefixime is a third-generation cephalosporin antibiotic. It works by interfering with the synthesis of the bacterial cell wall, leading to the death of the bacteria. It is highly stable in the presence of beta-lactamase enzymes, which allows it to be effective against many organisms that are resistant to penicillins and some other cephalosporins. The absorption of Cefixime is about 40-50% and 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. The usual course of treatment is 7 days, which can be extended to 14 days if needed.
• Elderly: Same as the adult dose, but renal function should be assessed and dosage adjusted in cases of severe renal impairment.
• Children (as a general guide): 8 mg/kg/day as a single dose or in two divided doses.
  • 6 months to 1 year: 3.75 ml daily.
  • 1-4 years: 5 ml daily.
  • 5-10 years: 10 ml daily.
• Typhoid in children: 5 mg/kg body weight twice daily for 10-14 days.
• Renal Impairment: The normal dose can be given if creatinine clearance is 20 ml/min or greater. If it is less than 20 ml/min, the dose should not exceed 200 mg once daily.

Interaction

• Anticoagulants: Cefixime may increase prothrombin times, so caution is advised in patients receiving anticoagulant therapy.

Contraindications

Fix-A is contraindicated in patients with a known hypersensitivity to cephalosporin antibiotics.

Side Effects

Fix-A is generally well-tolerated. Common side effects are usually mild and self-limiting, and may include:

• Gastrointestinal: Diarrhea (most frequent), nausea, abdominal pain, dyspepsia, vomiting, and flatulence. Pseudomembranous colitis has also been reported.
• Central Nervous System: Headache and dizziness.
• Hypersensitivity Reactions: Rash, itching, urticaria, drug fever, and joint pain.
• Hematological: Rare, reversible thrombocytopenia, leukopenia, and eosinophilia.

Pregnancy & Lactation

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

Precautions & Warnings

• Hypersensitivity: Use with caution in patients with a history of hypersensitivity to other drugs, especially penicillin-sensitive patients, due to the possibility of cross-allergenicity.
• Renal Impairment: Administer with caution to patients with significantly impaired renal function.
• Antibiotic-Associated Diarrhea: Like other broad-spectrum antibiotics, it may alter normal colon flora and cause diarrhea due to Clostridium difficile.

Overdose Effects

There is no specific antidote for an overdose. Gastric lavage may be considered. Cefixime is not removed by hemodialysis or peritoneal dialysis in significant quantities.

Storage Conditions

Keep below 30ºC, protected from light and moisture. Keep out of the reach of children.