Cefixime Powerful Action, Uses, Dosage, Side effects and Top 10 Brands In Pakistan

Introduction

Cefixime is a third-generation cephalosporin antibiotic widely used to treat various bacterial infections. It is recognized for its broad-spectrum antibacterial activity, making it effective against both Gram-positive and Gram-negative bacteria. This antibiotic is notably successful in treating respiratory tract infections, urinary tract infections, and uncomplicated gonorrhea. This antibiotic exerts its therapeutic effect by inhibiting the bacterial cell wall synthesis, ultimately destroying the bacteria.

History

Cefixime was patented in 1979 and approved for medical use in the United States in 1989. It is on the World Health Organization’s List of Essential Medicines and is available as a generic medication in the United States.

Chemical Composition and Structure

Cefixime has the chemical formula C16H15N5O7S2 and a molecular weight of 453.45 g/mol. Its structure includes a beta-lactam ring, crucial for its antibacterial activity. The presence of this ring allows Cefixime to bind to penicillin-binding proteins (PBPs) in bacteria, disrupting cell wall synthesis.

Mechanism of Action

Cefixime exerts its bactericidal effect by binding to penicillin-binding proteins (PBPs), essential for bacterial cell wall synthesis. By inhibiting these proteins, it prevents the formation of the peptidoglycan layer of the bacterial cell wall, leading to cell lysis and death.

Spectrum of Activity

Cefixime is effective against a wide range of bacteria, including:

Gram-positive bacteria

Gram-positive bacteria are a group of bacteria that retain the crystal violet stain when subjected to the Gram-staining method. This is due to their thick peptidoglycan layer in the cell wall, which traps the crystal violet-iodine complex. Gram-positive bacteria include Staphylococcus, Streptococcus, Pneumococcus, Clostridium, and Lactobacillus.

Gram-negative bacteria

Gram-negative bacteria are a group of bacteria that do not retain the crystal violet stain when subjected to the Gram-staining method of bacterial differentiation. Their defining characteristic is their cell envelope, consisting of a thin peptidoglycan cell wall sandwiched between inner (cytoplasmic) and outer membranes. Examples of Gram-negative bacteria include Neisseria, Haemophilus, Helicobacter pylori, Chlamydia trachomatis, Klebsiella, Acinetobacter, Pseudomonas aeruginosa, and E. coli.

Uses of Cefixime

Cefixime is a versatile antibiotic used to treat a variety of bacterial infections. Below are some of its common applications:

1. Respiratory Tract Infections

Cefixime is effective in treating various respiratory tract infections, including:

• Bronchitis: This is an inflammation of the bronchial tubes, the air passages between the mouth and the lungs. Cefixime helps in reducing infection and inflammation.
• Pharyngitis: An infection that causes inflammation of the pharynx, resulting in a sore throat. Cefixime helps to eliminate the bacteria causing the infection.
• Tonsillitis: Inflammation of the tonsils, typically caused by bacterial infections. Cefixime is used to treat the infection and alleviate symptoms.

2. Urinary Tract Infections (UTIs)

Cefixime is commonly used to treat urinary tract infections such as:

• Cystitis: An infection of the bladder. Cefixime works by killing the bacteria causing the infection, relieving symptoms such as pain and frequent urination.
• Pyelonephritis: A type of kidney infection that can result from bacteria traveling up from the bladder. It helps clear the bacteria from the kidneys and urinary tract.

3. Uncomplicated Gonorrhea

Cefixime is an effective treatment for uncomplicated gonorrhea, particularly for:

• Urethral: Infections in the urethra caused by Neisseria gonorrhoeae. Cefixime effectively treats these infections.
• Cervical: Infections in the cervix caused by the same bacteria. Cefixime helps eliminate the infection.
• Rectal: Gonococcal infections in the rectum. Cefixime is used to clear these infections.
• Pharyngeal: Throat infections caused by gonorrhea. Cefixime can treat these less common manifestations.

4. Otitis Media

Cefixime is used to treat middle ear infections, specifically:

Acute Otitis Media: This is an infection in the middle ear, common in children. Cefixime is effective in reducing infection and relieving pain and fever.

5. Sinusitis

Cefixime can be used for bacterial sinus infections, including:

Acute Bacterial Sinusitis: An infection of the sinuses causing inflammation and congestion. Cefixime helps clear the bacteria, reducing symptoms like headache, facial pain, and nasal congestion.

6. Skin and Soft Tissue Infections

Though less common, Cefixime is also used for certain skin and soft tissue infections, where it helps eliminate bacterial infections and reduce inflammation.

7. Typhoid Fever

It is sometimes prescribed for the treatment of typhoid fever, caused by:

Salmonella typhi: This bacterium causes high fever, weakness, stomach pains, headache, and loss of appetite. Cefixime helps by killing the bacteria, thereby alleviating symptoms and preventing complications.

 Cefixime uses in urdu

سیفیکسیم ایک ورسٹائل اینٹی بائیوٹک ہے جو مختلف بیکٹیریائی انفیکشنز کا علاج کرنے میں استعمال ہوتا ہے۔ یہاں کچھ عام استعمالات دی گئی ہیں:

تنفسی راہ کی انفیکشنز

سیفیکسیم مختلف تنفسی راہ کی انفیکشنز جیسے کہ:

برانکائٹس: یہ برونکیل ٹیوبوں کا انفلیمیشن ہوتا ہے، منہ اور فیفاواں کے درمیان ہوا کے راستے۔ سیفیکسیم اس انفیکشن اور انفلیمیشن کو کم کرنے میں مدد کرتا ہے۔ پھیرنگائٹس: یہ ایک انفیکشن ہے جو فیرنکس کا انفلیمیشن پیدا کرتا ہے، جس سے گلا سوج جاتا ہے۔ سیفیکسیم بیماری کو پیدا کرنے والے بیکٹیریا کو ختم کرنے میں مدد فراہم کرتا ہے۔ ٹانسیلائٹس: ٹانسل کا انفلیمیشن، عموماً بیکٹیریائی انفیکشن سے پیدا ہوتا ہے۔ سیفیکسیم بیماری کا علاج کرنے میں استعمال ہوتا ہے اور علامات کو کم کرتا ہے۔

مثانے کی انفیکشنز (UTIs)

سیفیکسیم عام طور پر مثانے کی انفیکشنز جیسے:

سسٹائٹس: پیشاب کی نالی کا انفیکشن۔ سیفیکسیم بیکٹیریا کو ختم کرنے میں مدد فراہم کرتا ہے، درد اور بار بار پیشاب آنے جیسے علامات کو دور کرتا ہے۔ پائیلونیفریٹس: پیشاب کی نالی سے اوپر بھیجنے سے پیدا ہونے والا کِدنی کا انفیکشن۔ سیفیکسیم گردوں اور پیشاب کی نالی سے بیکٹیریا کو ختم کرنے میں مدد فراہم کرتا ہے۔

غیر معقول گنوریا

سیفیکسیم غیر معقول گنوریا کا موثر علاج ہے، خاص طور پر:

یوریترال: نائزریا گنوریے سے پیدا ہونے والے یوریترا میں انفیکشن۔ سیفیکسیم ان انفیکشنز کا موثر علاج کرتا ہے۔ سرویکل: ایک ہی بیکٹیریا سے پیدا ہونے والے سرویکس میں انفیکشن۔ سیفیکسیم ان انفیکشن کو ختم کرتا ہے۔ ریکٹل: ریکٹم میں گنوکوکل انفیکشن۔ سیفیکسیم ان انفیکشن کو ختم کرنے میں مدد فراہم کرتا ہے۔ فیرنجیل: گنوریے سے پیدا ہونے والے گلے کے انفیکشنز۔ سیفیکسیم ان کم تر پائے جانے والے انفیکشنز کا علاج کرتا ہے۔

اوٹیٹس میڈیا

سیفیکسیم مڈل ائیر انفیکشنز کا علاج کرنے میں استعمال ہوتا ہے، خاص طور پر:

اکیوٹ اوٹیٹس میڈیا: یہ مڈل ائیر میں ایک انفیکشن ہے، بچوں میں عام ہوتا ہے۔

Dosage and Administration

The dosage of Cefixime varies based on the type and severity of the infection, as well as the patient’s age and kidney function.

Adult Dosage

• Respiratory tract infections: 400 mg once daily or 200 mg every 12 hours.
• UTIs: 400 mg once daily or 200 mg every 12 hours.
• Gonorrhea: A single dose of 400 mg.

Pediatric Dosage

• Otitis media: 8 mg/kg/day divided into two doses.
• Pharyngitis and tonsillitis: 8 mg/kg/day as a single dose or divided into two doses.

Administration

Cefixime can be taken with or without food. However, taking it with food may reduce gastrointestinal discomfort. It is available in various forms, including tablets, capsules, and oral suspension.

Side Effects of Cefixime

While Cefixime is generally well-tolerated, it can cause side effects in some individuals. Common side effects include:

Gastrointestinal

• Diarrhea: The most common side effect.
• Nausea and vomiting
• Abdominal pain

Allergic Reactions

• Rash
• Itching
• Anaphylaxis: A rare but severe allergic reaction.

Hematologic

• Eosinophilia
• Thrombocytopenia
• Leukopenia

Hepatic

• Elevated liver enzymes
• Hepatitis: Rare cases.

Renal

Elevated creatinine: Indicates potential kidney impairment.

Precautions and Contraindications

Certain precautions should be observed when taking Cefixime.

Allergies

Patients with a known allergy to cephalosporins or penicillins should avoid Cefixime due to the risk of cross-reactivity.

Renal Impairment

Dose adjustment is necessary for patients with renal impairment to prevent drug accumulation and toxicity.

Pregnancy and Breastfeeding

• Pregnancy: Cefixime falls under Category B, indicating no proven risk in humans. However, it should be used only if needed.
• Breastfeeding: Cefixime is excreted in breast milk in small amounts, so caution is advised.

Drug Interactions

Cefixime can interact with other medications, potentially altering its effectiveness or increasing the risk of adverse effects.

Anticoagulants

Warfarin: This antibiotic can enhance the effects of warfarin, increasing the risk of bleeding.

Nephrotoxic Drugs

Aminoglycosides: Concurrent use can increase the risk of kidney damage.

Probenecid

Probenecid can decrease the renal excretion of Cefixime, leading to higher serum levels and prolonged effects.

Cefixime Resistance

Antibiotic resistance is a growing concern with the use of Cefixime. Overuse and misuse of antibiotics contribute to the development of resistant bacterial strains.

Mechanisms of Resistance

• Beta-lactamase production: Some bacteria produce enzymes that deactivate Cefixime.
• Alteration of PBPs: Changes in penicillin-binding proteins can reduce the binding affinity of Cefixime.

Preventing Resistance

• Appropriate use: Use this drug only when prescribed by a healthcare provider.
• Completing the course: Ensure the course of the antibiotic is completed to prevent the survival of resistant bacteria.
• Avoiding misuse: Avoid antibiotics for viral infections like the common cold.

Cefixime vs. Other Antibiotics

Cefixime is compared with other antibiotics to determine the best treatment option for specific infections.

Cefixime vs. Amoxicillin

• Spectrum: Cefixime has a broader spectrum of activity compared to amoxicillin.
• Resistance: Amoxicillin is more prone to resistance due to widespread use.
• Indications: Cefixime is preferred for more severe or resistant infections.

Cefixime vs. Azithromycin

• Spectrum: Both have broad spectrums, but azithromycin is more effective against atypical pathogens.
• Dosing: Azithromycin typically has a shorter course of therapy.
• Side effects: Azithromycin has a higher risk of gastrointestinal side effects.

Patient Information and Education

Providing patients with comprehensive information about Cefixime is crucial for ensuring proper use and adherence to therapy.

How to Take

• Dosage instructions: Follow the prescribed dosage exactly as directed by the healthcare provider.
• With or without food: It can be taken with or without food, but taking it with food may reduce stomach upset.
• Missed dose: If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double up on doses.

What to Avoid

• Alcohol: While there is no direct interaction, alcohol can exacerbate side effects like stomach upset.
• Antacids: Some antacids can interfere with the absorption of Cefixime.

When to Seek Medical Help

• Allergic reactions: Seek immediate medical attention if signs of an allergic reaction occur, such as rash, itching, swelling, or difficulty breathing.
• Severe diarrhea: Persistent or severe diarrhea could indicate a more serious condition like Clostridioides difficile infection.

Brands in Pakistan

1. Blevo is manufactured by HEALTHTEK (PVT) LTD.
2. Maxima is manufactured by Macter Pharma.
3. Mixel is manufactured by a High-Q International pharmaceutical company.
4. Cebosh is manufactured by Bosch pharmaceuticals company.
5. Caricef is manufactured by Sami Pharmaceutical.
6. Cefim is manufactured by Hilton Pharma Limited.
7. Cefiget is manufactured by Getz Pharma.
8. Bacnel is manufactured by Smart Healer Pharmaceuticals.
9. Fixval is manufactured by G.S.K.
10. FIXITIL-T is manufactured by Tabros Pharma.
11. Cefspan is manufactured by Barret Phaarma.

Conclusion

Cefixime remains a vital antibiotic in the fight against bacterial infections. Its broad-spectrum activity, efficacy, and relatively favorable safety profile make it a valuable tool for healthcare providers. However, responsible use and awareness of potential side effects and interactions are crucial to maximize its benefits and minimize risks. As antibiotic resistance continues to rise, it is essential to use this antibiotic judiciously and adhere to prescribed guidelines to ensure its continued effectiveness.