NEFEXIM 100 DRY SYRUP

Indications

• Urinary tract infections
• Otitis media
• Pharyngitis
• Gonorrhea
• Bronchitis

Dosage

Children: Refer to the BNF for Children for appropriate dosing information based on the child's age and weight.

Adults: Refer to the BNF for specific dosing guidelines based on the type and severity of infection.

Mechanism of action

Cefixime works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, disrupting the cross-linking of peptidoglycan layers. This leads to the weakening of the cell wall, resulting in cell lysis and death of the bacteria. Cefixime is particularly effective against organisms that produce beta-lactamases, which can inactivate other antibiotics.

Pharmacodynamics

Cefixime exhibits time-dependent bactericidal activity. Its efficacy is influenced by the duration of time that the drug concentration remains above the minimum inhibitory concentration (MIC) for the target organism. The drug is generally well tolerated, with a side effect profile that includes gastrointestinal disturbances, allergic reactions, and potential changes in blood parameters. It displays a wide spectrum of activity against Streptococcus pneumoniae, Haemophilus influenzae, and Escherichia coli.

Pharmacokinetics

After oral administration, cefixime is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 2 to 6 hours post-dose. It has a bioavailability of around 40-50%. Cefixime is widely distributed throughout the body, including the lungs, kidneys, and biliary tract. The drug is primarily excreted unchanged in the urine, with a half-life of approximately 3 to 4 hours. Renal impairment may necessitate dosage adjustments.

Contra-indications

• Hypersensitivity to cefixime or any component of the formulation
• Previous severe allergic reaction to penicillins or other cephalosporins

Adverse effects

• Diarrhea
• Nausea
• Vomiting
• Abdominal pain
• Rash
• Urticaria
• Elevated liver enzymes
• Renal impairment
• Anaphylaxis (rare)
• Clostridium difficile-associated diarrhea

Interactions

• Antacids may reduce absorption of cefixime
• Probenecid may increase the serum concentration of cefixime
• Cefixime may enhance the effects of anticoagulants

Precautions

• Use with caution in patients with a history of gastrointestinal disease, particularly colitis
• Monitor renal function in patients with renal impairment
• Caution in patients with known allergies to beta-lactam antibiotics

Pregnancy

Cefixime is classified as Category B. Animal studies have not demonstrated a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed.

Breast-feeding

Cefixime is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Cefixime 200 mg tablets
• Cefixime 400 mg tablets
• Cefixime 100 mg/5 mL oral suspension