Cefixime

Pharmaceuticals -> Antibiotics

Pharmaceuticals -> Antibiotics

Pharmaceuticals -> Listed in ZINC15

Breast Feeding; Lactation; Anti-Infective Agents; Antibacterial Agents; Cephalosporins;

FDA approved drugs -> Active ingredient

FDA approved drugs -> Active ingredient

Watch group antibiotics

218-225 °C

218 - 225 °C

This chemical does not meet GHS hazard criteria for 0.9% (1 of 109) of reports.

Danger

H315 (59.6%): Causes skin irritation [Warning Skin corrosion/irritation]

P233, P260, P261, P264, P264+P265, P271, P272, P280, P284, P302+P352, P304+P340, P305+P351+P338, P319, P321, P332+P317, P333+P317, P337+P317, P342+P316, P362+P364, P403, P403+P233, P405, and P501 (click each P-code to see the statement)

Aggregated GHS information provided per 109 reports by companies from 7 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.

Drug Induced Liver Injury Rank (DILIrank 2.0)

Cefixime

vLess-DILI-concern

4

Adverse reactions

DOI:10.1016/j.drudis.2016.02.015

Cefixime

9.3

39.4

The recommended dose of cefixime is 400 mg daily.

Data used to generate the benchmarks include the following: Lowest Daily Dose (LDD): 400 mg/day, Lowest Therapeutic Dose (LTD): 5.0 mg/kg-day, and Screening Dose: 0.002 mg/kg-day.

2-Jan-20

J - Antiinfectives for systemic use

QJ - Antiinfectives for systemic use

J01DD08

Cefixime, a broad-spectrum antibiotic, is an orally-active third-generation semisynthetic cephalosporin. Like other cephalosporins, the antibacterial action of cefixime results from inhibition of cell wall synthesis. Also like other cephalosporins, cefixime is stable when in the presence of certain beta-lactamase enzymes, which means certain organisms resistant to penicillins and some cephalosporins due to the presence of beta-lactamases could be susceptible to cefixime. Use of cefixime can result in hypersensitivity reactions including anaphylactic/anaphylactoid reactions and _Clostridium difficile_-associated diarrhea (CDAD); it may also be associated with a fall in prothrombin activity. Cefixime doses should be adjusted for patients that have renal impairment and patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD), while patients on dialysis should be monitored while taking cefixime.

The bacterial cell wall, which is located at the periphery of Gram-positive bacteria and within the periplasm of Gram-negative bacteria, comprises a glycopeptide polymer synthesized through cross-linking of glycans to peptide stems on alternating saccharides, which is known commonly as peptidoglycan. Cell wall formation, recycling, and remodelling require numerous enzymes, including a family of enzymes with similar active site character despite distinct and sometimes overlapping roles as carboxypeptidases, endopeptidases, transpeptidases, and transglycosylases, known as "penicillin-binding proteins" (PBPs). The number of PBPs differs between bacteria, in which some are considered essential and others redundant. In general, inhibition of one or more essential PBPs results in impaired cell wall homeostasis, loss of cell integrity, and is ultimately bactericidal. Cefixime is a cephalosporin and cephalosporins work by using their beta-lactam rings to inhibit bacterial cell wall synthesis by binding to the penicillin-binding proteins transpeptidases on bacteria. The inhibition of synthesis of the bacteria cell wall will cause lysis, particularly in fast growing organisms such as bacteria. Specifically, cephalosporins inhibit penicillin-sensitive enzymes responsible for the final 3D structure of the bacterial cell wall which in turn inhibit bacterial cell wall peptidoglycan synthesis.

Cefixime has a serum half-life averaging 3 to 4 hours in healthy subjects and is independent of dosage form. It has ranged up to 9 hours in some normal volunteers. In individuals with severe renal impairment (5 to 20 mL/min creatinine clearance), the half-life of cefixime increased to an average of 11.5 hours.

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CEFIXIME ANHYDROUS

Established Pharmacologic Class [EPC] - Cephalosporin Antibacterial

Chemical Structure [CS] - Cephalosporins

Cefixime anhydrous is a Cephalosporin Antibacterial.

CEFIXIME

Agents that are structurally similar to other CEPHALOSPORINS but have a broader spectrum of activity against bacteria than the first and second generation cephalosporins. These agents cover more resistant STREPTOCOCCUS, STAPHYLOCOCCUS, gram-positive anaerobes, and more resistant strains of HAEMOPHILUS, NEISSERIA, PROTEUS, ESCHERICHIA COLI, and KLEBSIELLA (HNPEK).

With oral administration of cefixime, about 40%-50% is absorbed whether administered with or without food. However, time to maximal absorption is increased approximately 0.8 hours when administered with food. Cefixime administered as an single oral 200 mg tablet in healthy male volunteers had a corresponding Cmax of 3.25 mg/L and a corresponding Tmax of 4 hours. Administration of cefixime as a 200 mg oral solution in healthy volunteers results in a Cmax of 3.22 micrograms/mL, while administration of 200 mg and 400 mg cefixime capsules results in a Cmax of 2.92 micrograms/mL and 4.84 micrograms/mL, respectively. Administration of cefixime as a 200 mg intravenous solution, a 200 mg oral solution, a 200 mg capsule, and 400 mg capsule results in mean areas under the curve (AUC) of 47.0 μg.h/mL, 26.0 μg.h/mL, 23.6 μg.h/mL, and 39.4 μg.h/mL, respectively.

Approximately 50% of absorbed cefixime is excreted unchanged in the urine in 24 hours.

Cefixime has a volume of distribution averaging 0.1 L/kg of body weight when administered orally.

Cefixime administered as an oral suspension with a dose of 8 mg/kg in children with urinary tract infections aged from 6 to 13 years resulted in a mean apparent total clearance rate of 4.74 ml/min/kg.