How cefixime works
Cefixime has a bactericidal effect, i.e. it can kill bacteria.
Bacteria protect themselves from harsh environmental influences by forming a solid cell wall in addition to a cell membrane (as animal and human cells also have). This mainly gives the germs increased resistance to external influences such as varying salt concentrations in the environment.
When environmental conditions are favorable, bacterial cells divide continuously to reproduce (some bacteria even every twenty minutes). Each time, the stable cell wall must be broken down in a controlled manner and then replenished and crosslinked. The bacterial enzyme transpeptidase is responsible for the cross-linking between individual cell wall building blocks (sugar and protein compounds).
Beta-lactam antibiotics such as penicillins and cephalosporins (including cefixime) inhibit transpeptidase. The bacterial cell continues to try to divide, but after division it can no longer close the open areas of its cell wall – it dies. Cefixime is therefore also referred to as a “bactericidal antibiotic”.
This is capable of degrading beta-lactam antibiotics of the first generations, rendering them ineffective. However, cefixime is beta-lactamase stable, which makes it effective against a broader range of bacterial pathogens than other cephalosporins and the earlier penicillins.
Absorption, degradation and excretion
After ingestion as a tablet or dissolved in water, about half of cefixime is absorbed from the intestine into the blood, where it reaches peak blood levels after three to four hours.
Cefixime is not metabolized or broken down in the body and is largely carried out of the body by the kidneys. About four hours after ingestion, half is excreted in the urine.
When is cefixime used?
Cefixime is approved for the treatment of bacterial infections whose pathogens are sensitive to this antibiotic. These are, for example:
- Respiratory infections
- @ otitis media
- uncomplicated urinary tract infections
- uncomplicated gonorrhea (gonorrhea)
How cefixime is used
Usually, cefixime is taken in the form of tablets or as a suspension (made from granules or drinkable tablets). Usually, 400 milligrams of cefixime is prescribed once daily or 200 milligrams of cefixime twice daily for a period of five to ten days. For uncomplicated urinary tract infections in women, the doctor may also reduce the duration of intake to one to three days.
The antibiotic can be taken with or without a meal.
What are the side effects of cefixime?
The most common side effects that occur with cefixime treatment are diarrhea and soft stools, because the drug also attacks and kills beneficial intestinal bacteria.
Occasionally, one in one hundred to one thousand people treated also experience side effects in the form of headache, abdominal pain, indigestion, nausea, vomiting, elevated liver enzyme levels, dizziness, restlessness, and skin rashes.
If you experience signs of an allergic reaction (itching, rash, shortness of breath), you must notify a doctor and stop taking Cefixime.
What should be considered when taking Cefixime?
Contraindications
- hypersensitivity to the active substance, other cephalosporins, or any of the other components of the drug
- previous hypersensitivity reactions to a penicillin or beta-lactam antibiotic
Drug interactions
If the antibiotic cefixime is combined with other agents that affect kidney function, it may be greatly reduced. This applies, for example, to the antibiotics gentamycin, colistin, and polymyxin, as well as to potent dehydrating agents such as etacrynic acid and furosemide.
If cefixime is taken at the same time as the antihypertensive nifedipine, its absorption from the intestine into the blood is greatly increased (risk of severe drop in blood pressure!).
The additional intake of coumarin-type anticoagulant drugs (such as phenprocoumon and warfarin) can lead to an increased risk of bleeding. Therefore, coagulation values should be closely monitored during intake.
Age Limitation
Premature infants and neonates should not receive cefixime. Children and adolescents, however, may take the antibiotic in appropriately reduced doses.
Pregnancy and lactation
However, clinical experience to date has shown neither evidence of a risk of malformation nor relevant side effects in breastfed infants when mothers were treated with the antibiotic. According to experts, cefixime can therefore be used as indicated during pregnancy and breastfeeding.
How to obtain medicines containing cefixime
Cefixime is available by prescription in Germany and Austria in every dosage and package size. In Switzerland, the active ingredient is no longer on the market.
How long has cefixime been known?
The first cephalosporin was discovered in 1945 at the University of Cagliari (Italy). It was isolated from the fungus Cephalosporium acremonium (now Acremonium chrysogenum).
Because of its penicillin-like structure, researchers suspected that it could also yield effective antibiotics through targeted chemical modification. This was indeed the case, with one of the derivatives being cefixime – a third-generation cephalosporin.
