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Cefixime. A review of its antibacterial activity. Pharmacokinetic properties and therapeutic potential
R N Brogden1, D M Campoli-Richards
1ADIS Drug Information Services, Auckland, New Zealand.
Abstract:
Cefixime, previously designated FK027, FR17027 and CL284635, is an orally active cephalosporin with a broad spectrum of antibacterial activity in vitro. It is particularly active against many Enterobacteriaceae, Haemophilus influenzae. Streptococcus pyogenes, Streptococcus pneumoniae and Branhamella catarrhalis, and is resistant to hydrolysis by many beta-lactamases. Cefixime has little activity against Staphylococcus aureus and is inactive against Pseudomonas aeruginosa. Cefixime is distinguished by its 3-hour elimination half-life which permits twice daily, or in many instances once daily, administration. Comparative trials, though few, indicate that the clinical and bacteriological efficacy of cefixime 200 to 400mg daily administered as a single dose or in 2 divided doses, is comparable with that of multiple daily doses of co-trimoxazole (trimethoprim + sulphamethoxazole) or amoxycillin in acute uncomplicated urinary tract infection, with that of amoxycillin, amoxycillin/clavulanic acid and cefaclor in acute lower respiratory tract infections, and with that of amoxycillin and cefroxidine in adult patients with acute tonsillitis or pharyngitis. Several comparative trials in children with acute otitis media demonstrate the similar effectiveness of cefixime 8 mg/kg daily (in 2 divided doses, or as a single daily dose), cefaclor 20 to 40 mg/kg daily and amoxycillin 40 mg/kg daily in 3 divided doses. The most frequently reported adverse effects, diarrhoea and stool changes, are usually mild to moderate in severity, transient, and mostly occur in the first few days of treatment with cefixime. Thus, cefixime is an effective orally active cephalosporin with a relatively long elimination half-life permitting a simplified treatment regimen. It is a suitable alternative to cefaclor or amoxycillin in acute otitis media and acute upper and lower respiratory tract infections, and to amoxycillin or co-trimoxazole in acute uncomplicated urinary tract infections.
Insights
Cefixime is an effective oral cephalosporin antibiotic. Its broad-spectrum activity and convenient dosing make it a suitable alternative for various infections, including urinary tract and respiratory infections.
Area of Science:
- Pharmacology
- Infectious Diseases
- Microbiology
Background:
- Cefixime is an orally active cephalosporin antibiotic.
- It exhibits broad-spectrum activity against common bacterial pathogens.
- Cefixime demonstrates resistance to many beta-lactamases, enhancing its efficacy.
Purpose of the Study:
- To evaluate the efficacy and safety of cefixime.
- To compare cefixime with other antibiotics in treating various infections.
- To assess cefixime's suitability as an alternative treatment option.
Main Methods:
- In vitro susceptibility testing against various bacteria.
- Clinical trials comparing cefixime to co-trimoxazole, amoxycillin, cefaclor, and cefroxidine.
- Evaluation of efficacy in acute uncomplicated urinary tract infections, lower respiratory tract infections, tonsillitis/pharyngitis, and otitis media.
Main Results:
- Cefixime showed significant activity against Enterobacteriaceae, Haemophilus influenzae, Streptococcus pyogenes, Streptococcus pneumoniae, and Branhamella catarrhalis.
- Clinical trials indicated comparable efficacy of cefixime to comparator antibiotics in treating various infections.
- Adverse effects, primarily mild to moderate diarrhea and stool changes, were transient.
Conclusions:
- Cefixime is an effective oral cephalosporin with a favorable pharmacokinetic profile, allowing for simplified dosing regimens.
- It serves as a viable alternative to other antibiotics for treating acute otitis media, respiratory tract infections, and uncomplicated urinary tract infections.
- The safety profile of cefixime is generally favorable, with transient and mild gastrointestinal side effects.