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Cefixime (Suprax®)

By: Dr. Nicholas Dodman

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Overview

  • Recently relaunched by Lupin Pharmaceuticals, cefixime is a semisynthetic, cephalosporin oral antibiotic used to treat conditions including pneumonia, bronchitis, otitis, and urinary tract infections.
  • Like other cephalosporins, its bactericidal action results from inhibition of cell-wall synthesis, however, it is stable in the presence of beta-lactamase.
  • Many organisms resistant to penicillins and other cephalosporins because of beta- lactamase are susceptible to cefixime.
  • Organisms susceptible to cefixime include: Gram-positive Organisms: Streptococcus agalactiae, Streptococcus pneumoniae, and Streptococcus pyogenes. Gram-negative Organisms: Haemophilus influenzae and parainfluenzae (beta-lactamase positive and negative strains), Klebsiella pneumoniae and oxytoca, Moraxella (Branhamella) catarrhalis (most of which are beta-lactamase positive), Escherichia coli, Pasteurella multocida, Proteus mirabilis and vulgaris, Providencia and Salmonella species, Shigella species, Citrobacter amalonaticus, Citrobacter diversus, and Serratia marcescens.
  • Cefixime's oral bioavailability is about 50% in dogs. The suspension appears to be slightly more bioavailable than tablets. Food delays but does not otherwise affect its absorption. Approximately 23% of an absorbed dose of cefixime is excreted unchanged in the urine in 24 hours. Very little (0.2%) is excreted in bile. Cefixime is 65% bound to plasma protein and has a terminal half-life of 6.4 hours in dogs.
  • Cefixime is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Suprax® (Lupin Pharmaceuticals)
  • Veterinary formulations: None

    Uses of Cefixime

    Treatment of bacterial infections caused by susceptible organisms. Cefixime has been used to treat:
  • Endocarditis
  • Pneumonia
  • Bronchitis
  • Otitis
  • UTI

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, cefixime can cause side effects in some animals.
  • Cefixime should not be used in animals with known hypersensitivity or allergy to it or other cephalosporins.
  • The dose may need to be reduced in renal disease.
  • Adverse reactions include: hypersensitivity reactions, anaphylactic/anaphylactoid reactions, angioedema, facial edema, hepatitis, jaundice, gastrointestinal disturbance, acute renal failure, seizures, toxic epidermal necrolysis, neutropenia, and hyperbilirubinemia.
  • The dose of any concurrently administered anticoagulant should be decreased when cefixime is being administered and coagulation parameters should be monitored

    Drug Interactions

  • Cefixime may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with cefixime. Such drugs include certain other antibiotics.
  • Probenecid blocks the renal excretion of cefixime, increasing blood levels.
  • Warfarin and other anticoagulants may have their effects increased (see above).

    How Cefixime is Supplied

  • Cefixime is available as 400 mg film-coated tablets and as a powder for oral suspension.
  • The oral suspension contains 100 mg/5 ml.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • In dogs, the usual dose is 2.5 to 5 mg per pound (5 to 10 mg/kg) every 12 hours for 7 to 14 days.
  • In cats, no dose data is available.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.



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