Cefixime - instructions for use, dose, side effects, contraindications

Has bactericidal action due to inhibition of bacterial cell wall synthesis. Violates the synthesis of the biopolymer peptidoglikana - the main component of the cell wall of bacteria. It inhibits the peptidoglycan transpeptidase, inhibits the activity of the endogenous inhibitor, which leads to activation of murein hydrolase, which cleaves peptidoglycan. Effective against fissile bacteria, in the walls of which the synthesis of peptidoglycan occurs.

It is active against gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes; Gram-negative bacteria: Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, E. coli, Proteus mirabilis, N. gonorrhoeae.

To cefixime are stable: Pseudomonas spp., Enterococcus (Streptococcus) serogroup D, Listeria monocytogenes and most strains Staphylococcus spp. (including methicillin-resistant strains), Enterobacter spp., Bacteroides fragilis, Clostridium spp.

Resistant to the action of β-lactamases.

Pharmacokinetics:

After oral administration, regardless of food intake, up to 40-50% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved after 2.5-4.5 hours. The connection with plasma proteins is 65%.

Not exposed to metabolism. Does not penetrate the blood-brain barrier. Do not cumulate.

The elimination half-life is 3-4 hours. Elimination with bile and kidneys in unchanged form.

Indications:

It is used to treat infections caused by microorganisms sensitive to cefixime: respiratory tract (acute and chronic bronchitis, pneumonia, pleurisy); bile ducts (cholangitis, cholecystitis); in otorhinolaryngological practice (sinusitis, tonsillitis, pharyngitis, otitis media); diseases of the urinary tract (cystitis, pyelonephritis, endometritis, prostatitis); infections of the skin, soft tissues and bones; for the treatment of scarlet fever. There are data on the use of cefixime for the treatment of gonorrhea, cystic fibrosis and intestinal infections in children.

ICD-10

I.A50-A64.A54 Gonococcal infection

VIII.H65-H75.H66 Purulent and unspecified otitis media

X.J00-J06.J00 Acute nasopharyngitis (runny nose)

X.J30-J39.J31.1 Chronic nasopharyngitis

X.J30-J39.J31 Chronic rhinitis, nasopharyngitis and pharyngitis

X.J00-J06.J01 Acute Sinusitis

X.J30-J39.J32 Chronic Sinusitis

X.J30-J39.J31.2 Chronic pharyngitis

X.J00-J06.J02 Acute pharyngitis

X.J00-J06.J03 Acute tonsillitis

X.J30-J39.J35.0 Chronic tonsillitis

X.J00-J06.J04 Acute laryngitis and tracheitis

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

X.J20-J22.J20 Acute bronchitis

X.J40-J47.J42 Chronic bronchitis, unspecified

X.J40-J47.J40 Bronchitis, not specified as acute or chronic

XIV.N10-N16.N11 Chronic tubulointerstitial nephritis

XIV.N10-N16.N10 Acute tubulointerstitial nephritis

XIV.N30-N39.N30 Cystitis

XIV.N30-N39.N34 Urethritis and urethral syndrome

XIV.N30-N39.N39.0 Urinary tract infection without established localization

XIV.N40-N51.N41 Inflammatory diseases of the prostate

XIV.N70-N77.N74.3 * Gonococcal inflammatory diseases of female pelvic organs (A54.2 +)

Contraindications:

Individual intolerance of β-lactam antibiotics: penicillins and cephalosporins, neonatal period.

Carefully:

Children under 6 months of age, electrolyte or fluid imbalance, history of bronchial asthma, severe liver damage, malabsorption syndrome.

Pregnancy and lactation:

Recommendations for FDA - Category B. It is used in pregnancy and lactation.

Dosing and Administration:

Use in children

Up to 12 years - by mouth, 8 mg / kg once a day or 4 mg / kg every 12 hours.

Adults

Inside, regardless of food intake, 200 mg twice a day, with uncomplicated gonorrhea - 400 mg once.

The highest daily dose: 400 mg.

The highest single dose: 400 mg.

Side effects:

Central and peripheral nervous system: headache, dizziness.

Hemopoietic system: leukopenia, thrombocytopenia, hemolytic anemia, eosinophilia, hypoprothrombinemia.

Digestive system: nausea, vomiting, diarrhea, cholestatic jaundice, pseudomembranous colitis, increased activity of hepatic transaminases, hepatitis.

Dermatological reactions: hyperhidrosis, rash, itching, candidiasis.

Urinary system: interstitial nephritis.

Allergic reactions.

Overdose:

Increased side effects.

Treatment is symptomatic.

Interaction:

Reduces the prothrombin index, increases the effect of indirect anticoagulants.

When used simultaneously with aminoglycosides, butadione, polymyxins, the risk of nephrotoxicity increases.

Increase the effect of aminoglycosides, metronidazole, polymyxins, rifampicin, weaken - levomitsetin, tetracyclines.

Kolestyramin reduces the absorption of cefixime.

Special instructions:

Control of prothrombin time and bleeding time.

During treatment, a false positive Coombs reaction and a false positive urine reaction to glucose are possible.

Instructions

Cefixim (Cefiximum)