Cefixime

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Cefixime

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Cefixime

Cefixime is an orally active, semisynthetic beta-lactam antibiotic used to combat a wide spectrum of bacterial infections. Its fundamental purpose is to function as a powerful antimicrobial agent to effectively kill invading bacteria. The drug, which is available only by prescription (Rx status), was first approved for use in the United States in 1989.

Property Description
Active ingredient Cefixime
Form Tablet, Capsule, Oral Suspension
Pharmacological class Third-generation Cephalosporin
Common use Systemic bacterial infections
Origin Semisynthetic compound

What Type of Antibiotic is Cefixime?

Cefixime is classified as a third-generation cephalosporin, placing it in the broader beta-lactam antibiotic family. This classification identifies it as a semisynthetic compound chemically engineered to offer a broad-spectrum of activity, particularly against many Gram-negative bacteria. Pharmacological studies have widely confirmed its enhanced stability against degradation by bacterial enzymes known as beta-lactamases, a common mechanism of resistance. This resilience is a key differentiator from older cephalosporins, allowing Cefixime to be a choice for managing a wide range of susceptible bacterial infections when resistance is a concern.


Cefixime's General Purpose and Activity

The core function of Cefixime is its bactericidal action, meaning it actively causes the destruction of susceptible bacterial cells, a mechanism clinically recognized for its efficacy in rapidly reducing pathogen load. This effect is achieved by the compound interfering with the final stages of bacterial cell wall synthesis. The general purpose of this medicine is therefore to facilitate the clearance of infection in scenarios such as managing community-acquired bacterial diseases.


Composition and Available Dosage Forms

The medicine is supplied as a single-agent product where the active ingredient is Cefixime (often as Cefixime trihydrate). It is designed exclusively for oral administration, and is available in multiple dosage forms including tablets, capsules, and powder for oral suspension. The availability of an oral liquid suspension makes Cefixime especially useful for pediatric patients (six months of age or older), offering a practical and non-invasive way to administer the full dose.

What side effects are possible with Cefixime?

Possible Side Effects and Safety Information

This section outlines the adverse reactions and safety considerations for Cefixime as documented in official government regulatory sources (e.g., FDA, EMA).

Frequency-Classified Adverse Reactions

Classification Examples of Reactions
Most Common Diarrhea, loose stools, abdominal pain, nausea, vomiting, dyspepsia, headache.
Uncommon Rash, transient elevations of liver enzymes (ALT, AST).
Very Rare Severe skin reactions (SJS, TEN), hepatitis, cholestatic jaundice.

Serious Adverse Reactions

Regulatory warnings focus on clinically significant and potentially severe risks, including:

  • Hypersensitivity Reactions: Immediate discontinuation is required if signs of severe allergic reactions (e.g., anaphylaxis, angioedema) or severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS) or Toxic Epidermal Necrolysis (TEN), appear.
  • Clostridium difficile-Associated Diarrhea (CDAD): This condition, ranging from mild diarrhea to fatal colitis, may occur during or up to two months following treatment.
  • Acute Organ Effects: Acute renal failure (including tubulointerstitial nephritis), seizures (convulsions), and changes in blood cell counts (e.g., thrombocytopenia, leukopenia) have been reported.

Safety Considerations and Restrictions

  • Allergy Risk: Cefixime is contraindicated in individuals with a known allergy to cephalosporin antibiotics. Caution is necessary for those with a history of penicillin allergy due to the potential for cross-hypersensitivity.
  • Renal Impairment: Dose adjustment is mandatory for patients with significantly impaired kidney function (e.g., creatinine clearance < 60 mL/min). Monitoring of kidney function is advised for elderly patients and those with existing impairment.
  • Drug Interactions and Lab Tests: Caution is advised when co-administering with anticoagulants like warfarin, as Cefixime may prolong prothrombin time. The drug can cause a false-positive direct Coombs test and interference with certain urine glucose tests.
  • Superinfection Risk: Prolonged use may result in the overgrowth of non-susceptible organisms.

Overdose and Emergency Response

Overdose and When to Seek Help

Official regulatory information addresses the recognized risks and required actions in the event of Cefixime overdosage.

Overdose presentations are generally expected to involve an exaggeration of known adverse effects, primarily those affecting the gastrointestinal tract, such as diarrhea and vomiting.

Serious Risks and Emergency Action

A more serious potential risk documented for cephalosporins, including Cefixime, is Central Nervous System toxicity, which can manifest as seizures (convulsions). This risk is particularly noted in patients with renal impairment where the drug clearance is compromised. The potential for seizures necessitates immediate medical evaluation.

Immediate medical attention must be sought if an overdose is suspected, including contacting emergency services or a Poison Help line.

Management and Constraints

There is no specific antidote available to reverse the effects of Cefixime. Management is entirely supportive and symptomatic. While procedures such as gastric lavage may be considered, official information confirms that Cefixime is not removed in significant quantities by hemodialysis or peritoneal dialysis.

Treatment focuses on stabilizing the patient and managing symptoms, such as the administration of anticonvulsant therapy if seizures occur.

Therapeutic Uses of Cefixime

What Cefixime Helps Manage: Main Uses and Benefits

The medication is relevant for managing conditions characterized by acute symptoms across several key domains.

Cefixime is commonly used across conditions presenting with acute episodes that involve symptoms related to physical discomfort, such as those seen in uncomplicated urinary tract infections (UTIs), acute otitis media, pharyngitis/tonsillitis, and acute exacerbations of chronic bronchitis. It is also relevant for managing specific systemic conditions, including uncomplicated gonorrhea and typhoid fever. This broad use may assist with easing the overall symptom burden during difficult episodes.

“It is applied across domains where additional symptomatic support is needed, helping to address symptom clusters that may become intense or disruptive.”

This approach assists with maintaining functional stability by addressing the underlying issue of symptoms related to inflammatory or irritative states, such as ear pain, sore throat, fever, and the burning sensation during urination (dysuria). Cefixime is often used in clinical settings that involve acute or unstable symptom patterns in both adult and pediatric patient groups.

Quick Fact: Supportive Relief for Acute Discomfort
May support comfort during acute episodes of ear pain and dysuria (burning during urination).

Regulatory References

  1. NIH DailyMed Label for Cefixime

Eligibility and Restrictions for Use

This section outlines the official eligibility and non-eligibility rules for cefixime based strictly on governmental regulatory documents.

Eligibility and Non-Eligibility

Classification Populations Defined by Official Labeling
Populations Allowed Adults and pediatric patients six months of age and older.
Contraindicated Individuals with known hypersensitivity to cefixime, other cephalosporin antibacterial agents, or a history of severe immediate hypersensitivity to any other beta-lactam antibiotic (e.g., penicillins).

Restrictions and Special Considerations

Category Regulatory Status and Constraint
Age-Related Safety and efficacy have not been established in infants less than six months of age.
Renal Function Patients with markedly impaired renal function require a restricted, adjusted dose. Use in pediatric and adolescent patients with severe renal insufficiency is not recommended due to insufficient data.
Specific Formulations The chewable tablet is constrained for use in individuals with Phenylketonuria (PKU) because it contains phenylalanine.
Pregnancy/Lactation Use during pregnancy should be only if clearly needed. Temporary discontinuation of nursing should be considered during lactation.

These constraints define the official population profile for cefixime use, with eligibility rooted in the absence of absolute contraindications and the presence of established safety data for the age group.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Cefixime has been documented to interact with specific medicinal products, primarily impacting blood coagulation and the plasma concentration of certain anticonvulsants.

Interacting Product Category Observed Effect
Anticoagulants (e.g., Warfarin) Increased prothrombin time and elevated risk of bleeding, which may or may not include observable clinical hemorrhage.
Carbamazepine Elevated plasma levels of carbamazepine have been reported when co-administered. Monitoring of carbamazepine concentrations may be necessary.

In addition to drug-drug interactions, cefixime interferes with specific laboratory procedures. The use of cefixime may cause a false-positive reaction for ketones in the urine when tests use nitroprusside. Similarly, it can cause a false-positive reaction for glucose in the urine when using tests based on cupric sulfate, such as Benedict’s solution or Fehling's solution; therefore, glucose tests based on enzymatic glucose oxidase reactions are recommended for accurate results. A false-positive direct Coombs test has also been reported with cephalosporins, including cefixime.

Mechanism of Action

The action of Cefixime is fundamentally bactericidal, focused on the molecular machinery that builds the bacterial protective layer.

Irreversible Blockade of Cell Wall Construction

Cefixime exerts its effect by acting as an irreversible inhibitor of bacterial enzymes known as Penicillin-Binding Proteins (PBPs), such as PBP-3 and PBP-1a/1b. This covalent blockade specifically targets and halts the transpeptidase activity, which is the final step in synthesizing the bacteria's rigid peptidoglycan cell wall. This molecular interference sets the stage for the destruction of the pathogen.

Causal Cascade to Pathogen Lysis

The structural defect caused by inhibiting peptidoglycan cross-linking renders the bacterial cell wall incomplete and fatally weak. This allows the high internal osmotic pressure to overwhelm the cell's integrity, leading to rapid swelling and the formation of unstable spheroplasts that rupture. This sequence culminates in bacterial cell lysis (destruction), which is the core physiological effect that results in a reduction of the viable pathogen population.

Mechanistic Constraint by Bacterial Resistance

While Cefixime demonstrates chemical stability against many common beta-lactamases, the mechanism can be overridden by highly effective bacterial defenses. The failure occurs either when bacteria produce Extended-Spectrum beta-Lactamases (ESBLs), which chemically inactivate the drug, or when they genetically acquire Altered Penicillin-Binding Proteins that reduce the drug's essential binding affinity. These are the biological situations that constrain the drug's intended action.

Dosage and Administration Information

Administration Guidelines: How to Use Cefixime

Cefixime is an oral antibacterial agent and must be taken only by mouth. The official administration guidelines define the exact regimen, preparation, and adjustments required for correct use.

Dosing and Frequency

Population Standard Dosing and Frequency
Adults (and Children ge 12 years or >45 kg) 400 mg once daily (QD) or 200 mg every 12 hours (BID).
Pediatric Patients (ge 6 months) 8 mg/kg per day, given as a single daily dose or in two divided doses.

All doses should be taken at approximately the same time(s) each day. Cefixime may be administered with or without food.

Preparation and Administration Specifics

  • Solid Forms (Tablets/Capsules): Tablets may be split if scored to achieve a 200 mg dose. Capsules must be swallowed whole. Chewable tablets must be chewed or crushed completely before swallowing.
  • Oral Suspension (Liquid): The powder must be reconstituted by adding the specified amount of water and shaking well. The suspension must be shaken well immediately before each measured dose is administered using a calibrated device.

Population-Specific Instructions and Duration

Kidney Function Adjustment: The dose must be reduced for patients with severely impaired kidney function (Ccr le 60 mL/min). For example, a dose of 200 mg once daily is required for severe renal impairment.

Missed Dose: If a dose is missed, take it as soon as remembered. If it is almost time for the next scheduled dose, skip the missed dose. Do not take a double dose.

The prescribed duration of the full course must be completed, which typically ranges from seven to fourteen days, and for specific infections (e.g., those caused by S. pyogenes), must be taken for at least ten full days.

Recent Clinical Evidence

Research evidence / Overview of studies for Cefixime


Evidence for Use in Uncomplicated Urinary Tract Infections (UTIs)

Cefixime was studied for conditions characterized by fluctuating or episodic manifestations, such as uncomplicated urinary tract infections. The research included both short-term Randomized Controlled Trials (RCTs) and observational settings. These studies monitored changes in clinical status and research examined how researchers measured the status of the bacteria causing the infection, which is often termed bacteriological status. Outcomes related to physical discomfort, like the burning sensation during urination (dysuria), were studied for Cefixime in the context of uncomplicated urinary tract infections.

Studies conducted during periods of increased symptom activity reported measurements of both clinical and bacteriological status following the short-term treatment period. The evidence base includes multiple trials and reflects long-standing use, but the focus remains on short-term data.


Evidence for Use in Acute Otitis Media (AOM) and Pharyngitis

In the context of acute ear infections (Acute Otitis Media) and throat infections (Pharyngitis/Tonsillitis), Cefixime was evaluated in short-term Randomized Controlled Trials (RCTs). These studies explored outcomes related to episodic or acute changes, such as assessing changes in the appearance of the eardrum and monitoring the resolution of symptoms like ear pain and fever in children and adults. For pharyngitis, the research examined if the Streptococcus bacteria were monitored and how the overall clinical status changed.

Findings indicate patterns relating to measured changes in clinical status and the documented monitoring of bacteria in the observed populations. Evidence quality varies across studies based on how many participants were included and how the studies were designed. The outcomes measured in studies of AOM can be affected by local changes in bacterial resistance.


Long-Term Studies and Follow-up Durations

Most research for Cefixime was studied for research exploring short-term symptom changes and acute infection episodes. The follow-up durations were limited, typically lasting only the duration of the treatment course and a short period immediately afterward. This means that while the studies help show what has been observed so far during the immediate treatment phase, there is limited information for long-term outcomes.

Key Studies & References

  1. Label: CEFIXIME capsule - DailyMed - NIH (Indications, Pediatric Use, Uncomplicated UTIs, AOM, Pharyngitis/Tonsillitis, AECB, Gonorrhea)

Frequently Asked Questions (FAQ)

Common questions about Cefixime (FAQ)

Q: What types of bacterial infections is Cefixime typically used to treat?

According to official product labeling, Cefixime is indicated for the treatment of certain bacterial infections. These typically include uncomplicated infections of the urinary tract, acute infections of the middle ear (otitis media), throat and tonsils (pharyngitis and tonsillitis), and acute exacerbations of chronic bronchitis. It is also approved for the treatment of uncomplicated gonorrhea.


Q: Can Cefixime cause a false positive drug test or medical test?

Regulatory information indicates that Cefixime can interfere with certain laboratory tests. It may cause a false-positive result for ketones and glucose in the urine when specific testing methods are used, and it can cause a false-positive direct Coombs test. Regulatory labeling does not specifically address interference with common workplace or illegal drug screenings.


Q: Can I take Cefixime if I have a history of an allergic reaction to Penicillin?

Official labeling advises caution when Cefixime is used in individuals who have a history of penicillin allergy. This is due to the potential for cross-hypersensitivity with penicillin. However, Cefixime is contraindicated (not permitted for use) for individuals with a known allergy to the drug, other cephalosporin antibiotics, or a history of severe immediate hypersensitivity to any other beta-lactam antibiotic.


Q: What is the minimum duration I must take Cefixime for, even if I feel better?

Official prescribing information generally emphasizes that the full prescribed course of treatment should be completed. For infections caused by the bacteria Streptococcus pyogenes (which causes strep throat), the therapeutic dosage of Cefixime is administered for at least 10 full days. Specific treatment duration is determined by the healthcare provider.


Q: What is the maximum daily dose of Cefixime for adults?

The recommended adult dose for many common bacterial infections is listed in the official labeling as a certain daily amount. For example, the dose for uncomplicated gonorrhea is a single oral amount. The specific dose and frequency are determined by the healthcare provider based on the infection being treated.


Q: Can Cefixime be used to treat viral infections?

Cefixime is classified as an antibacterial drug. Official information states that it should only be used to treat infections that are either proven or strongly suspected to be caused by bacteria. Antibacterial medications, including Cefixime, are not effective against viral infections like the common cold or the flu.


Q: Where in the body does Cefixime reach its highest concentration after taking a dose?

Studies and official information indicate that after being absorbed, Cefixime is distributed throughout the body. The pharmacokinetic data suggests that relatively high concentrations of the medication may be achieved in fluids such as the bile and the urine.

How should Cefixime be stored and disposed of?

Cefixime must be stored in its original, tightly closed container and kept out of the reach of children. Store capsules, tablets, and chewable tablets at room temperature away from excessive heat and moisture, such as the bathroom.

The reconstituted oral suspension (liquid) has specific requirements:

  • Storage: Store the liquid either at room temperature or in the refrigerator.
  • Expiration: Dispose of any unused liquid antibiotic after 14 days from the date it was prepared, even if it was refrigerated.

Do not use any cefixime product if it is expired or no longer needed. Consult your pharmacist or local government for guidance on proper drug disposal. Do not flush medication down the toilet or pour it down a drain unless specifically instructed to do so by the labeling.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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