Cefixima

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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 Cefixima

What is Cefixima?

Cefixime is an oral antibiotic medication belonging to the third-generation cephalosporin class. It is used to treat a variety of bacterial infections by interfering with the way bacteria build their cell walls, which ultimately leads to the elimination of the infection.

Therapeutic Class and Mechanism

As a beta-lactam antibiotic, cefixime is characterized by its broad-spectrum activity. It is designed to be stable in the presence of certain beta-lactamase enzymes, which are substances produced by some bacteria to resist antibiotic treatment. By binding to specific penicillin-binding proteins inside the bacterial cell wall, cefixime inhibits the final stage of bacterial wall synthesis.

Common Applications

Cefixime is typically utilized for infections involving the respiratory tract, the urinary system, and certain middle ear infections. Because it is effective against various Gram-positive and Gram-negative organisms, it is often prescribed for:

  • Urinary Tract Infections (UTIs): Uncomplicated infections of the bladder and kidneys.
  • Respiratory Infections: Including acute bronchitis and bacterial flare-ups of chronic bronchitis.
  • Ear, Nose, and Throat Infections: Such as otitis media (middle ear infection), pharyngitis, and tonsillitis.
  • Sexually Transmitted Infections: Specifically uncomplicated gonorrhea.

Chemical Properties

Unlike many other cephalosporins in its class that require injection, cefixime is chemically formulated for oral absorption. This allows for the treatment of moderate infections in an outpatient setting while maintaining the bacterial coverage associated with third-generation cephalosporins.

What side effects are possible with Cefixima?

Cefixime's safety profile is documented by regulatory authorities, with adverse reactions generally categorized by frequency and the body system affected. The most frequently observed adverse events are classified as Common and typically relate to the Gastrointestinal System.


Adverse Reaction Categories and Frequency

Official labeling classifies common adverse effects, including diarrhea, nausea, loose or frequent stools, abdominal pain, and dyspepsia. Less frequent reactions reported include headache, dizziness, and transient laboratory changes affecting the Hepatobiliary and Renal Systems, such as elevated liver enzymes or creatinine.


Serious Adverse Reactions and Safety Constraints

Regulatory documents highlight the risk of serious but rare events. These include life-threatening anaphylactic/anaphylactoid reactions and severe skin conditions like Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). The medication is associated with the potential for Clostridium difficile-associated diarrhea (CDAD), which may occur during or after therapy.

Safety constraints noted in official labeling include the risk of cross-hypersensitivity with penicillins and other beta-lactam antibiotics. Furthermore, dosage adjustment is specified for patients with significant renal impairment to mitigate the risk of neurological effects, such as seizures. The safety and effectiveness of Cefixime have not been established in children younger than six months of age.

Overdose and Emergency Response

The official regulatory documents define the Cefixime overdose profile by outlining documented acute clinical manifestations and required immediate actions. Overdose is primarily associated with excessive exposure, potentially leading to gastrointestinal disturbances such as diarrhea, nausea, vomiting, and abdominal pain. More serious manifestations involve the Central Nervous System, including the potential for seizures or convulsions. Transient elevations in liver enzymes and renal function parameters (BUN, creatinine) have also been reported.

Individuals with impaired renal function are noted to be at an increased risk of seizures due to reduced drug clearance leading to higher plasma concentrations.

In the event of a suspected overdose, regulatory guidance mandates that individuals seek emergency medical attention immediately. Emergency services must be contacted if severe symptoms such as collapse, difficulty breathing, or seizures are present. Management of Cefixime overdose is limited to symptomatic and supportive treatment, as no specific antidote is known. The official documentation specifies that procedures such as hemodialysis and peritoneal dialysis are ineffective for drug clearance, as they remove only insignificant quantities of Cefixime from the body.

Therapeutic Uses of Cefixima

What Cefixime Treats: Main Uses and Benefits

Cefixime is an oral, broad-spectrum antibacterial agent commonly used for managing certain acute bacterial infections, which may assist in easing the associated symptoms related to physical discomfort. The medication is indicated for the treatment of several key infections.


Therapeutic Scope and Patient Benefit

The medication is applied in clinical settings marked by acute inflammation and pain, particularly across the respiratory and genitourinary domains. It is considered relevant for managing conditions such as otitis media, pharyngitis, tonsillitis, acute exacerbations of chronic bronchitis, uncomplicated urinary tract infections (UTIs), and uncomplicated gonorrhea.

Its use is associated with addressing the bacterial cause, which can help support the patient during episodes by easing the overall symptom load and contributing to improved day-to-day comfort. The medication is considered relevant as a therapeutic choice for patients who may require an effective antibiotic but have a known sensitivity to the penicillin class.

Quick Fact: Relief for Acute Discomfort Cefixime is commonly used when symptoms related to localized inflammation and systemic fever become more disruptive, assisting with the stabilization of acute symptom patterns across multiple body systems.

Regulatory References

  1. NIH DailyMed Cefixime Indications

Eligibility and Restrictions for Use

Who Can and Cannot Use Cefixima?

Eligibility for Cefixime use is strictly defined by regulatory authorities based on age, hypersensitivity history, and pre-existing medical conditions.

Eligibility Status Patient Population / Condition
Absolute Contraindication Patients with known hypersensitivity to Cefixime or any other cephalosporin drug [Source 2.7].
Conditional Use / Caution Patients with a history of penicillin allergy (due to risk of cross-hypersensitivity); those with a history of colitis or other gastrointestinal diseases [Source 1.3, 2.2].
Age-Related Rule Safety and effectiveness have not been established in infants under six months of age [Source 1.4].
Conditional Use / Caution Adults with markedly impaired renal function (Creatinine Clearance <60 mL/min) require close observation [Source 2.3].
Physiological State Use in pregnant women is permitted only if clearly needed. Nursing mothers should consider temporarily discontinuing nursing during treatment [Source 1.8].

The medicine is indicated for use in non-restricted adult patients and pediatric patients six months of age and older. Specific formulations, such as chewable tablets, have restrictions for patients with Phenylketonuria (PKU). The profile explicitly states who must not use the medicine and under what labeled conditions it can be used.

What should I know about interactions with other medicines?

Cefixima, a third-generation cephalosporin antibiotic, has documented interactions primarily concerning blood clotting, anticonvulsant activity, and effects on other drug levels.

Interactions with Blood Thinners

Cefixima may enhance the effects of anticoagulants such as warfarin, leading to an increase in Prothrombin Time (PT) and International Normalized Ratio (INR), with or without clinical bleeding. The mechanism is believed to involve the cephalosporin class's potential to affect vitamin K-dependent clotting factors, often through altering intestinal flora. Patients stabilized on oral anticoagulants or those with kidney/liver impairment or poor nutritional status are at increased risk, and frequent monitoring of coagulation parameters is advised upon starting or stopping Cefixima.

Effects on Other Drug Levels

Concomitant use of Cefixima and carbamazepine has been reported to cause elevated carbamazepine serum concentrations. Monitoring of carbamazepine levels is recommended when these drugs are administered together. Additionally, probenecid is known to increase Cefixima’s plasma concentration (AUC and peak concentration) and prolong its half-life by decreasing its renal clearance. Conversely, a high oral dose of salicylates may result in a small decrease in Cefixima's plasma concentration.

Laboratory Test Interference

Cefixima may cause a false-positive reaction for ketones in the urine when tests using nitroprusside are employed. A false-positive Coombs test has also been reported with cephalosporin use, which should be considered in hematologic testing and in newborns whose mothers received the drug prior to birth.

Mechanism of Action

Disabling Bacterial Structure

Cefixime's primary mechanism involves the targeted inhibition of specific bacterial enzymes known as Transpeptidases (or Penicillin-Binding Proteins, PBPs). The drug forms a covalent and irreversible bond with the active site of these enzymes, permanently disabling them. This action directly interrupts the final cross-linking step within the peptidoglycan synthesis pathway, which is essential for constructing a stable and functional bacterial cell wall.


The Bactericidal Cascade

The consequence of this enzyme blockade is the inability of the bacteria to complete its wall structure, rendering the new cell envelope unstable and weak. The internal osmotic pressure, no longer contained by a rigid wall, causes the bacterial cell to rupture and rapidly die. This destructive cellular process, known as cell lysis, leads to a direct bactericidal effect against susceptible organisms, which defines the drug's physiological consequence.

Dosage and Administration Information

How to Use Cefixime

Cefixime (Cefixima) is administered exclusively via the oral route for systemic use. It is available in pharmaceutical forms including a capsule or film-coated tablet, typically in a 400 mg strength, and as a powder for oral suspension. The general usage instructions define the appropriate dose and schedule based on clinical labeling.


Administration Scope and Schedule

Feature Official Guideline
Route of administration Oral (by mouth) only.
Standard Adult Dose 400 mg per day.
Frequency Pattern Once daily (as a single 400 mg dose) OR divided 200 mg doses twice daily (every 12 hours).
Timing in relation to meals May be administered without regard to food.
Preparation Requirements Oral Suspension powder requires reconstitution with water as specified on the label before initial use.

Population and Duration Requirements

The required treatment course generally spans 7 to 14 days, but specific protocols, such as for infections caused by Streptococcus pyogenes, mandate a minimum duration of 10 days. For pediatric patients aged 6 months or older, the dose is 8 mg/kg/day, administered once or divided. Dosage adjustments are required for patients with confirmed renal impairment, where the dose must be reduced based on creatinine clearance, potentially to 300 mg or 200 mg daily. This protocol defines the standardized approach to the medication's use.

Recent Clinical Evidence

Research Evidence Overview for Cefixime

Cefixime has been evaluated in research exploring its role in settings involving certain short-term bacterial infections. The primary body of evidence comes from controlled investigations, such as Randomized Controlled Trials (RCTs), where its activity was studied in cohorts alongside other antibacterial protocols or placebo. This evidence base is used in research exploring the medicine's role and limitations.


Research Evidence for Acute Otitis Media and Upper Respiratory Infections

Research has extensively examined the use of Cefixime in conditions characterized by fluctuating or episodic manifestations, such as Acute Otitis Media (AOM) and throat infections. For AOM, studies were conducted in pediatric patients (children) and adults, and they monitored outcomes related to physical discomfort, specifically measuring both changes in external symptoms and the rate at which the targeted bacteria were cleared. Regulatory summaries noted that some trials described patterns where the measured response rate differed when evaluating activity against specific bacteria, such as Streptococcus pneumoniae. For throat infections, evidence is limited concerning whether the use of Cefixime can prevent the development of long-term complications, such as rheumatic fever, following a strep throat infection.


Clinical Studies for Urinary Tract Infections (UTIs)

Cefixime was studied for managing uncomplicated urinary tract infections. The studies explored two key outcomes: clinical success (patient-reported outcomes describing perceived discomfort and symptom changes) and microbiological success (lab results confirming a sterile urine culture). Research provides context into short-term changes, examining microbiological clearance and symptom changes observed in some studies. Despite these findings, the research landscape continually notes that patterns related to emerging antibiotic resistance among common urinary pathogens were described in surveillance data.


Evidence Context for Gonococcal Infections

Research examined the role of Cefixime in uncomplicated gonococcal infections. Surveillance reports have consistently documented a trend of increasing Minimum Inhibitory Concentrations (MICs), which is associated with changes in bacterial susceptibility patterns. For pharyngeal infections, research highlights that measurements of cure were less reliable, meaning evidence quality varies across studies depending on the location of the infection.

Frequently Asked Questions (FAQ)

Common questions about Cefixima (FAQ)


Q: What is Cefixima most commonly prescribed for?

According to the official product information, Cefixima is approved to treat a range of infections caused by susceptible bacteria. These include uncomplicated infections of the urinary tract, throat infections (pharyngitis and tonsillitis), and acute exacerbations of chronic bronchitis. It is also used in the treatment of uncomplicated gonorrhea.


Q: What kind of bacteria does Cefixima target?

Official microbiological information describes Cefixima as being effective against both susceptible Gram-negative and Gram-positive bacteria. This includes common strains such as Escherichia coli, Proteus mirabilis, Haemophilus influenzae, and the bacteria that causes strep throat, Streptococcus pyogenes.


Q: How is Cefixima different from Amoxicillin?

Cefixima is classified as a third-generation cephalosporin, which is a different class of antibiotic than Amoxicillin, which belongs to the penicillin class. Because these two drug classes are chemically related, official warnings note the potential risk of cross-hypersensitivity reactions between them.


Q: Why might a doctor prescribe Cefixima instead of another antibiotic?

Regulatory guidance on Cefixima's microbiological properties indicates that the drug is stable against certain bacterial enzymes called beta-lactamases. This stability may allow Cefixima to be effective against bacteria that have become resistant to some other penicillins or older cephalosporin antibiotics.


Q: What should I do if I experience a rash while taking Cefixima?

The official product information warns about the risk of hypersensitivity reactions, which can include serious skin conditions such as Stevens-Johnson Syndrome. If signs of a hypersensitivity reaction, such as a rash, occur, regulatory documents state that the medication is typically discontinued.


Q: Are there studies on how Cefixima affects gut flora?

Regulatory documents address Cefixima's potential influence on the intestinal environment, noting a risk of extitClostridium difficile-associated diarrhea (CDAD). Furthermore, the mechanism for Cefixima's interaction with the blood thinner warfarin is believed to involve alteration of the bacteria (flora) in the intestines.


Q: Why is Cefixima sometimes prescribed for a shorter duration than other antibiotics?

The required duration of Cefixima therapy is defined by official documents and depends entirely on the type and severity of the infection being treated. For instance, specific bacterial infections, such as those caused by Streptococcus pyogenes, require a minimum treatment course of 10 days to ensure effectiveness.


Q: What information is available about Cefixima's use in patients with liver conditions?

Official adverse reaction reports indicate that transient elevations in liver enzymes have been observed in some patients using Cefixima. Regulatory prescribing information, however, specifies dosage adjustments for patients with kidney problems (renal impairment), but not specifically for liver impairment.


Q: What documents describe the safety profile of Cefixima in older adults?

Official regulatory labeling addresses the use of Cefixima in the elderly population. It is noted that dedicated clinical studies in subjects aged 65 and over were limited, but the clinical experience documented so far has not generally identified differences in safety or effectiveness compared to younger adult patients.


Q: How quickly does Cefixima start working after the first dose?

Official pharmacological data describes the rate at which the drug enters the body's circulation. For Cefixima tablets or capsules, the maximum concentration in the bloodstream is typically reached about four hours after the dose is taken.


Q: What happens if I miss a scheduled dose of Cefixima?

General patient information outlines the recommended procedure for missed doses. This procedure usually involves taking the dose when remembered, unless it is close to the next scheduled time, and specifies that a patient should not double the dose to compensate.


Q: Do I need to finish the entire course of Cefixima even if I feel better?

The full treatment course is specified by regulatory guidance and supports the goal of clearing the infection completely. This full prescribed duration helps to mitigate the risk of developing drug-resistant bacteria.


Q: Is it normal to feel tired while taking Cefixima?

While severe tiredness is not among the most frequently observed side effects, less common adverse event reports have included feelings of weakness, general malaise, or unusual tiredness. These reports are documented in official safety surveillance data.


Q: Are there any specific foods or drinks to avoid while on Cefixima?

Official administration guidelines state that Cefixima may be taken without regard to food, meaning it can be administered with or without a meal. However, some general patient guidance notes that excessive consumption of iron-enriched foods or drinks may potentially influence the medicine's activity.


Q: Can I take pain relievers like ibuprofen with Cefixima?

Specific interactions between Cefixima and pain relievers like ibuprofen are not explicitly detailed as major in official drug labels. Nevertheless, regulatory documents caution that Cefixima should be used carefully with other medicines that affect blood clotting or those known to cause irritation in the digestive system.


Q: How long does Cefixima stay in the system after the last dose?

Pharmacological data from regulatory documents states that Cefixima has an average plasma half-life of approximately 3 to 4 hours in healthy adults. It is generally understood that a drug is cleared from the system after five to seven half-lives.


Q: Is Cefixima the generic name, or is it a brand name?

The name Cefixime is the established generic name for the active drug ingredient. The medication is also sold under various brand names globally.


Q: Can Cefixima cause yeast infections?

Official safety information indicates that the use of this antibiotic may lead to a secondary infection, such as candidiasis, which is commonly known as a yeast infection. This type of fungal superinfection may affect the mouth or the vagina.


Q: Is Cefixima effective against common cold or flu viruses?

Cefixima is classified as an antibacterial medicine and is intended only for treating infections that are caused by susceptible bacteria. Official indications state that it is not effective against viral infections, such as the common cold, influenza (flu), or other infections not caused by bacteria.


Q: What is the difference between Cefixima and Cephalexin?

Both Cefixima and Cephalexin belong to the cephalosporin class of antibiotics, but they are from different generations. Cefixima is a third-generation agent, whereas Cephalexin is a first-generation agent, resulting in differences in the specific range of bacteria they are effective against.


Q: Can I consume alcohol moderately while taking Cefixima?

Core regulatory labels do not consistently report a major, established interaction between Cefixima and alcohol consumption. Official patient safety guidelines recommend that patients discuss alcohol consumption with their healthcare provider during treatment.


Q: How long do the side effects of Cefixima usually last?

Official patient information reports that common adverse effects, such as mild stomach upset or diarrhea, are typically mild and of short duration. These reactions are generally expected to gradually lessen as the body adjusts to the medication or after the treatment course is finished.


Q: Can Cefixima be crushed or chewed if it is a tablet?

Official patient instructions state that Cefixima capsules should not be cut, broken, or chewed. Tablet modifications are generally not recommended unless specific guidance is received regarding that formulation. The oral suspension (liquid) is intended for those who cannot swallow solid forms.


Q: Is Cefixima prescribed for lung infections like bronchitis?

Yes, the official indications for Cefixima include the treatment of bacterial lung infections. Specifically, it is indicated for the management of acute exacerbations of chronic bronchitis caused by susceptible organisms.


Q: What is the meaning of the official safety rating or classification for Cefixima?

Cefixima is officially classified as a semisynthetic beta-lactam antibiotic belonging to the third-generation cephalosporins group. This medication is classified by regulatory bodies as a Prescription Only Medicine (Rx), meaning it can only be obtained with an authorization from a healthcare provider.


Q: Does Cefixima have a high risk of interaction with antacids?

Some official patient information recommends caution regarding certain stomach acid reducers. Antacids, such as cimetidine or ranitidine, may potentially decrease the body's absorption of Cefixima, which could impact its effectiveness.

How should Cefixima be stored and disposed of?

How to Store and Dispose of Cefixima?

Cefixima storage and disposal requirements are defined by regulatory agencies to ensure the medicine remains effective and is discarded safely.

Product Form Storage Temperature Stability/Protection
Tablets/Capsules/Powder Controlled Room Temperature (20 C to 25 C) Protect from moisture and light.
Reconstituted Suspension Room Temp or Refrigerated Must be discarded after 14 days. Do not freeze.

Solid forms and the powder for suspension must be kept in the original, tightly closed container and protected from excess heat, light, and moisture. The liquid suspension must be shaken well before each use. All medicine must be stored safely, out of the reach of children and pets. Do not dispose of unused Cefixima by flushing it down a toilet or pouring it into a drain; discard it according to local guidelines or a drug take-back program.

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

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