Cefixime is a cephalosporin antibiotic used to treat certain bacterial infections. These include uncomplicated urinary tract infections, middle ear infections, tonsillitis, pharyngitis, and acute flare-ups of chronic bronchitis.

It works by preventing bacteria from building the cell wall they need to survive. This kills susceptible bacteria and helps clear the infection.

Cefixime is approved by the FDA and is available by prescription in the United States. It should only be used for infections that are proven or strongly suspected to be caused by bacteria that are susceptible to this antibiotic.

What is cefixime used for?

Cefixime may be prescribed to treat bacterial infections such as:

Uncomplicated urinary tract infections;
Middle ear infections, such as otitis media;
Tonsillitis;
Pharyngitis;
Acute exacerbations of chronic bronchitis.

Cefixime is also FDA-approved to treat uncomplicated gonorrhea of the cervix or urethra caused by susceptible bacteria. However, ceftriaxone is currently the CDC-recommended treatment for uncomplicated gonorrhea, while cefixime may be used as an alternative in certain situations when ceftriaxone administration is not available or feasible.

Cefixime should only be taken under the direction of an infectious disease specialist, pulmonologist, ear, nose and throat specialist, urologist, primary care provider, or pediatrician, depending on the infection being treated.

How to take cefixime

Cefixime is taken by mouth and may be taken with or without food.

This medication is available as capsules, film-coated tablets, chewable tablets, or an oral suspension.

Cefixime dosing

The cefixime dosage depends on the formulation prescribed.

1. Cefixime 400 mg

Cefixime 400 mg is available as capsules or film-coated, scored tablets.

The usual recommended dosage for adults and children over 12 years old or weighing more than 45 kg (99 lb) is:

Indication	Dosage
Uncomplicated urinary tract infections, tonsillitis, pharyngitis, or acute exacerbations of chronic bronchitis	400 mg of cefixime once a day. The length of treatment should be determined by a doctor based on the type of infection.
Uncomplicated cervical or urethral gonorrhea	The FDA-labeled dosage is 400 mg of cefixime as a single dose. However, current CDC guidance recommends ceftriaxone as the preferred treatment. When ceftriaxone is not available or feasible, cefixime 800 mg taken by mouth as a single dose may be prescribed as an alternative.
Middle ear infections	Chewable tablets or oral suspension should generally be used instead of standard tablets or capsules.

Cefixime 400 mg capsules or tablets should be taken with a glass of water.

The capsules should not be opened or chewed. A scored 400 mg tablet may be divided into two equal halves when the prescribed dosage is 200 mg every 12 hours.

2. Cefixime 200 mg

Cefixime 200 mg, as well as the 100 mg and 150 mg strengths, may be available as chewable tablets.

The usual total dosage for adults and children over 12 years old or weighing more than 45 kg (99 lb) is 400 mg per day. When prescribed by a doctor, this may be taken as one 200 mg dose every 12 hours.

Cefixime 200 mg may be prescribed for uncomplicated urinary tract infections, middle ear infections, tonsillitis, pharyngitis, or acute exacerbations of chronic bronchitis. The length of treatment should be determined by a doctor.

Chewable tablets must be chewed or crushed before swallowing.

3. Cefixime oral suspension

Cefixime oral suspension may be available in concentrations of 100 mg/5 mL, 200 mg/5 mL, and 500 mg/5 mL.

For children 6 months and older, the usual recommended dosage is 8 mg/kg per day. It may be given as one daily dose or divided into two doses of 4 mg/kg approximately every 12 hours.

Suggested daily doses based on the child’s weight include:

Child’s weight	100 mg/5 mL suspension	200 mg/5 mL suspension	500 mg/5 mL suspension
5 to 7.5 kg (11 to 16.5 lb)	2.5 mL per day	-	-
7.6 to 10 kg (16.8 to 22 lb)	4 mL per day	2 mL per day	-
10.1 to 12.5 kg (22.3 to 27.6 lb)	5 mL per day	2.5 mL per day	1 mL per day
12.6 to 20.5 kg (27.8 to 45.2 lb)	7.5 mL per day	4 mL per day	1.5 mL per day
20.6 to 28 kg (45.4 to 61.7 lb)	10 mL per day	5 mL per day	2 mL per day
28.1 to 33 kg (61.9 to 72.8 lb)	12.5 mL per day	6 mL per day	2.5 mL per day
33.1 to 40 kg (73 to 88.2 lb)	15 mL per day	7.5 mL per day	3 mL per day
40.1 to 45 kg (88.4 to 99.2 lb)	17.5 mL per day	9 mL per day	3.5 mL per day
More than 45 kg (99.2 lb)	20 mL per day	10 mL per day	4 mL per day

The dose and length of treatment with cefixime oral suspension should always be determined by a pediatrician based on the type and severity of the infection.

The oral suspension comes as a powder that must be mixed with water before use. Shake the bottle well before each dose and measure the medication using the dosing device provided with the product.

After it has been mixed, the suspension may be stored in the refrigerator or at room temperature between 68°F and 77°F (20°C and 25°C) for up to 14 days. Any medication remaining after this period should be discarded.

Possible side effects

The most common side effects of cefixime include:

Diarrhea;
Nausea;
Loose stools;
Abdominal pain;
Indigestion;
Vomiting.

Less common side effects may include intestinal gas, yeast infections, agitation, confusion, angioedema, hives, impaired kidney function, or elevated liver enzymes.

Cefixime can also cause a severe allergic reaction, including anaphylaxis or anaphylactic shock. Emergency medical care should be sought immediately if symptoms such as difficulty breathing, swelling of the face or throat, severe dizziness, or fainting occur.

Severe or persistent diarrhea may be a sign of Clostridioides difficile-associated diarrhea and should be evaluated by a doctor, even if it develops after cefixime treatment has ended.

Who should not take cefixime?

Cefixime should not be used by people who:

Are allergic to cefixime or another cephalosporin antibiotic;
Have previously experienced a serious immediate allergic reaction to cefixime or a similar antibiotic.

The safety and effectiveness of cefixime have not been established in babies younger than 6 months.

People who have had an allergic reaction to penicillin should tell their doctor before taking cefixime, as an allergic reaction to both types of antibiotics may occur.

Cefixime chewable tablets may contain aspartame, which is a source of phenylalanine. People with phenylketonuria should inform their doctor so that their total daily phenylalanine intake can be evaluated.

During pregnancy, cefixime should only be used when prescribed by a doctor after the expected benefits and potential risks have been considered.

It is not known whether cefixime passes into human breast milk. Before it is used during breastfeeding, a doctor should consider the benefits of breastfeeding, the need for treatment, and any potential risks to the nursing baby.

People with diabetes should check the ingredients and carbohydrate content of the specific oral suspension prescribed, as some formulations may contain sucrose.

People who take carbamazepine, warfarin, or other anticoagulants should only use cefixime under medical supervision. Cefixime may increase carbamazepine levels or prolong blood-clotting time, which can increase the risk of bleeding.

People with impaired kidney function may need a lower cefixime dose.

Cefixime: Uaes, How to Take, Dosing & Side Effects