Cefixime Dosage

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Usual Adult Dose for Urinary Tract Infection

Uncomplicated infections: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Otitis Media

Oral suspension, chewable tablets: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Tonsillitis/Pharyngitis

400 mg orally once a day or 200 mg orally every 12 hours

Comments:
-Penicillin is the usual drug of choice for the treatment of Streptococcus pyogenes infections. Cefixime is generally effective in the eradication of S pyogenes from the nasopharynx; however, its efficacy in the subsequent prevention of rheumatic fever has not been established.

Usual Adult Dose for Bronchitis

Acute exacerbations of chronic bronchitis: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Gonococcal Infection - Uncomplicated

Uncomplicated cervical/urethral infections: 400 mg orally as a single dose

Centers for Disease Control and Prevention (CDC) recommendations:
Uncomplicated infections of the cervix, urethra, or rectum: 400 mg orally as a single dose plus (azithromycin [preferred] or doxycycline) plus test-of-cure in 1 week

Comments:
-The CDC regimen is recommended as an alternative if ceftriaxone is not available.
-The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Gonococcal Infection - Disseminated

(Not approved by FDA)

CDC recommendations: 400 mg orally twice a day

Comments:
-Initial therapy for disseminated gonococcal infections requires parenteral therapy which should be continued for 24 to 48 hours after clinical improvement is observed. Oral therapy may then be administered to complete a total course of at least 1 week.
-Doxycycline therapy for 7 days (if not pregnant) or single-dose azithromycin is also recommended to treat possible concurrent chlamydial infection.
-The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for STD Prophylaxis

(Not approved by FDA)

CDC recommendations for sexual assault victims: 400 mg orally as a single dose plus metronidazole plus (azithromycin or doxycycline)

Usual Pediatric Dose for Otitis Media

Oral suspension, chewable tablets:
6 months to 12 years (weighing 45 kg or less): 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours
Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Pediatric Dose for Urinary Tract Infection

Uncomplicated infections:
6 months to 12 years (weighing 45 kg or less):
Oral suspension, chewable tablets: 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours

Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Pediatric Dose for Tonsillitis/Pharyngitis

6 months to 12 years (weighing 45 kg or less):
Oral suspension, chewable tablets: 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours

Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Comments:
-Penicillin is the usual drug of choice for the treatment of Streptococcus pyogenes infections. Cefixime is generally effective in the eradication of S pyogenes from the nasopharynx; however, its efficacy in the subsequent prevention of rheumatic fever has not been established.

Usual Pediatric Dose for Bronchitis

Acute exacerbations of chronic bronchitis:
6 months to 12 years (weighing 45 kg or less):
Oral suspension, chewable tablets: 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours

Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Pediatric Dose for Gonococcal Infection - Uncomplicated

(Not approved by FDA)

American Academy of Pediatrics recommendations:
8 years or older weighing 45 kg or more: 400 mg orally as a single dose

CDC recommendations:
Uncomplicated infections of the cervix, urethra, or rectum in adolescents: 400 mg orally as a single dose plus (azithromycin [preferred] or doxycycline) plus test-of-cure in 1 week

Comments:
-The CDC regimen is recommended as an alternative if ceftriaxone is not available.
-The patient's sexual partner(s) should also be evaluated/treated.

Usual Pediatric Dose for Gonococcal Infection - Disseminated

(Not approved by FDA)

CDC recommendations for adolescents: 400 mg orally twice a day

Comments:
-Initial therapy for disseminated gonococcal infections requires parenteral therapy which should be continued for 24 to 48 hours after clinical improvement is observed. Oral therapy may then be administered to complete a total course of at least 1 week.
-Doxycycline therapy for 7 days (if not pregnant) or single-dose azithromycin is also recommended to treat possible concurrent chlamydial infection.
-The patient's sexual partner(s) should also be evaluated/treated.

Usual Pediatric Dose for STD Prophylaxis

(Not approved by FDA)

CDC recommendations for adolescent sexual assault victims: 400 mg orally as a single dose plus metronidazole plus (azithromycin or doxycycline)

Renal Dose Adjustments

Adults, children weighing more than 45 kg or older than 12 years:
CrCl 21 to 59 mL/min:
-Oral suspension (preferred concentrations are 200 mg/5 mL or 500 mg/5 mL): 260 mg orally once a day
-Tablets, chewable tablets: Not recommended.

CrCl 20 mL/min or less:
-100 mg/5 mL oral suspension: 172 mg orally once a day
-200 mg/5 mL oral suspension: 176 mg orally once a day
-500 mg/5 mL oral suspension: 180 mg orally once a day
-Tablets, chewable tablets: 200 mg orally once a day

Liver Dose Adjustments

Data not available

Precautions

Consult WARNINGS section for dosing related precautions.

Safety and effectiveness have not been established in pediatric patients less than 6 months of age.

Dialysis

Adults, children weighing more than 45 kg or older than 12 years:
Hemodialysis:
-Oral suspension (preferred concentrations are 200 mg/5 mL or 500 mg/5 mL): 260 mg orally once a day
-Tablets, chewable tablets: Not recommended.

CAPD:
-100 mg/5 mL oral suspension: 172 mg orally once a day
-200 mg/5 mL oral suspension: 176 mg orally once a day
-500 mg/5 mL oral suspension: 180 mg orally once a day
-Tablets, chewable tablets: 200 mg orally once a day

Comments:
-Neither hemodialysis nor peritoneal dialysis removes significant amounts of drug from the body.
-Patients on dialysis should be monitored carefully.

Other Comments

Administration advice:
-Children weighing more than 45 kg or older than 12 years should be treated with the usual adult dose.
-In the treatment of infections due to Streptococcus pyogenes, a therapeutic dose should be administered for at least 10 days.
-Tablets or capsules should not be substituted for the oral suspension or chewable tablets in the treatment of otitis media.
-Tablets and capsules may be given without regard to food. Chewable tablets must be chewed or crushed before swallowing.
-Oral suspension should be shaken well before each dose.

Storage requirements:
-Tablets, capsules, chewable tablets: Store at controlled room temperature.
-Oral suspension: Store at controlled room temperature prior to reconstitution; store at room temperature or under refrigeration for 14 days after reconstitution (discard after 14 days).

Reconstitution/preparation techniques:
-The manufacturer's product information should be consulted.

General:
-Chewable tablets contain 3.3 mg, 5 mg, and 6.7 mg of phenylalanine per 100 mg, 150 mg, and 200 mg strength, respectively.

Monitoring:
-Cardiovascular: Prothrombin time in patients at risk.

Patient advice:
-Patients should avoid missing doses and complete the entire course of therapy.

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