ONCE DAILY SR-CEFIXIME

Cefixime is an oral third generation cephalosporin active against most of

gram positive and gram negative bacteria except Staphylococcus aurious.
Clinical studies have confirmed efficacy of Cefixime in acute otitis media,
sinusitis and tosillopharyngitis.

Once daily administration and safety profile increases compliance and

decreases failure rate. It has a role as switch over therapy from
intravenous ceftriaxone in serious respiratory tract infections (RTIs).

In areas where common respiratory pathogens show decreased sensitivity

to penicillins and macrolides Cefixime can be used as empirical first line
therapy in respiratory tract infections. It seems to be a promising molecule
in pediatric typhoid fever because of its excellent activity against
Salmonella species but clinical trials are limited.

Dosage is 8 mg/kg/day ONCE for 5 days whereas co-amoxyclave is 40

mg/kg/day TDS for 10-15 days. There is no dosage adjustment for liver
failure patient unlike co-amoxyclave. There is no food drug interaction
unlike co-amoxyclave. Cephalosporin is the only antibiotic segment which
is safe in pregnancy and lactation. It safe up to 3 months baby therefore
used in pediatric Typhoid fever.

The orally active third-generation cephalosporin cefixime is a primary

candidate for switch therapy owing to its very good efficacy and safety
profile. Preliminary studies have shown excellent clinical outcomes with
switch therapy to cefixime after 2-3 days for a variety of serious infections.

Importantly, dramatic cost benefits have also been found, particularly with
respect to reduced length of hospital stays. Once daily dose of cefixime in
sustain release could be an added advantage in treating infection more
conveniently and effectively.

Cefixime is approved drug in India and in the world separately for bacterial
infection from head to toe and it is an ideal choice for RTI, ENT and Soft
skin tissue infection.

The cefixime in sustain release would be boon for the medical fraternity in
terms of convenient once a dose in treating extended spectrum
betalactamase infection. This sustain release combination could be an
economical for the patient and easy to prescribe the physician as well.
Cefixime has more mileage in terms of efficacy, safety and dosage
convenience in comparison to other available treatment options.
 Reference

1. Cefixime for switch therapy. Chemotherapy. 1998 Sep;44 Suppl

1:24-7.Chemotherapy. 1998 Sep;44 Suppl 1:24-7.Hamilton-Miller
J.Department of Medical Microbiology, Royal Free Hospital School
of Medicine, London, UK
2. Cefixime: an oral option for the treatment of multidrug-resistant
enteric fever in children. South Med J. 1997 Dec;90(12):1204-
7.Memon IA, Billoo AG, Memon HI Department of Pediatrics, Dow
Medical College, Civil Hospital, Karachi, Pakistan.
3. Comparison of the efficacy, safety and acceptability of cefixime and
amoxicillin/clavulanate in acute otitis media.Gooch WM 3rd, Philips
A, Rhoades R, Rosenberg R, Schaten R, Starobin S.Pediatr Infect
Dis J. 1997 Feb;16(2 Suppl):S21-
4. Open study of the safety and efficacy of a single oral dose of
cefixime for the treatment of gonorrhea in pregnancy.Miller
JM.Infect Dis Obstet Gynecol. 1997;5(3):259-61.

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DR.MOHD SHAHBAZ ALAM-9818131498, shahbaz@meherpharma.com