Prescribing Cefixime: What Doctors Need to Know
Cefixime is a third‑generation oral cephalosporin that many clinicians reach for when they need a reliable antibiotic that works well against common bacteria. It’s especially handy for infections where a pill is easier than an IV, like uncomplicated urinary tract infections or certain respiratory bugs.
When to Choose Cefixime and Typical Dosage
The usual go‑to situations are:
- Uncomplicated gonorrhea (single 400 mg dose)
- Mild to moderate pneumonia caused by susceptible strains
- Acute otitis media in kids when amoxicillin isn’t an option
- Urinary tract infections, especially when the patient can’t take TMP‑SMX
For most adults, the standard dose is 400 mg once daily for five days. Kids get a weight‑based dose—8 mg/kg per day, divided into one or two doses. Adjustments are needed if the patient has kidney problems; you’ll typically cut the dose in half or extend the interval.
Safety Checks and Common Interactions
Cefixime is generally well tolerated, but watch for diarrhea, nausea, or a mild rash. Severe allergic reactions are rare but can happen—if a patient has a known penicillin or cephalosporin allergy, skip it.
Drug interactions aren’t huge, but keep an eye on:
- Warfarin: Cefixime may boost INR, so monitor clotting levels.
- Oral contraceptives: Some reports say antibiotics lower effectiveness; advise backup contraception.
- Probenecid: Can raise cefixime blood levels and increase side‑effects.
If the patient is pregnant, cefixime falls into Category B—studies haven’t shown major risks, but you still want to limit exposure to antibiotics unless clearly needed.
Before writing a script, confirm that lab cultures show susceptibility. Blindly prescribing can drive resistance and waste money. If culture results are pending, consider local antibiograms for guidance.
Finally, remind patients to finish the full course—even if they feel better after a couple of days. Stopping early gives surviving bacteria a chance to become resistant, which makes future infections tougher to treat.
A doctor's perspective on prescribing cefixime
May, 6 2023