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Cefixime Disease Interactions

There are 5 disease interactions with cefixime:

Moderate

Antibiotics (Includes Cefixime) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  4. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  5. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  6. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  7. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  8. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  9. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  10. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  11. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  12. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  13. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  14. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  15. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  16. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  17. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  18. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  19. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  20. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  21. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  22. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  23. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  24. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  25. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  26. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  27. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  28. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  29. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  30. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  31. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  32. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  33. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  34. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  35. "Multum Information Services, Inc. Expert Review Panel"
  36. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  37. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  38. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  39. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  40. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  41. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  42. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
  43. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  44. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  45. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
  46. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
  47. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
View all 47 references
Moderate

Beta-Lactams (Oral) (Includes Cefixime) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.

References

  1. Sjovall J, Westerlund D, Alvan G "Renal excretion of intravenously infused amoxycillin and ampicillin." Br J Clin Pharmacol 19 (1985): 191-201
  2. DeSante KA, Zeckel ML "Pharmacokinetic profile of loracarbef." Am J Med 92 (1992): s16-9
  3. "Product Information. Geocillin (carbenicillin)." Roerig Division, New York, NY.
  4. Jackson EA, McLeod DC "Pharmacokinetics and dosing of antimicrobial agents in renal impairment, part I." Am J Hosp Pharm 31 (1974): 36-52
  5. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc, Baltimore, MD.
  6. Solomon AE, Briggs JD "The administration of cephradine to patients in renal failure." Br J Clin Pharmacol 2 (1975): 443-8
  7. Therasse DG, Farlow DS, Davidson RL, et al. "Effect of renal dysfunction on the pharmacokinetics of loracarbef." Clin Pharmacol Ther 54 (1993): 311-6
  8. St Peter JV, Borin MT, Hughes GS, et al "Disposition of cefpodoxime proxetil in healthy volunteers and patients with impaired renal function." Antimicrob Agents Chemother 36 (1992): 126-31
  9. Latos DL, Bryan CS, Stone WJ "Carbenicillin therapy in patients with normal and impaired renal function." Clin Pharmacol Ther 17 (1975): 692-700
  10. Guay DR, Meatherall RC, Harding GK, Brown GR "Pharmacokinetics of cefixime (CL 284,635; FK 027) in healthy subjects and patients with renal insufficiency." Antimicrob Agents Chemother 30 (1986): 485-90
  11. Nix DE, Symonds WT, Hyatt JM, et al. "Comparative pharmacokinetics of oral ceftibuten, cefixime, cefaclor, and cefuroxime axetil in healthy volunteers." Pharmacotherapy 17 (1997): 121-5
  12. Fillastre JP, Leroy A, Humbert G, Godin M "Cefaclor pharmacokinetics and renal impairment." J Antimicrob Chemother 6 (1980): 155-6
  13. Guay DRP "Ceftibuten: A new expanded-spectrum oral cephalosporin." Ann Pharmacother 31 (1997): 1022-33
  14. Nakano H, Sasaki K, Mizoguchi M, Ishibe T, Nihira H "Absorption and excretion of carbenicillin indanyl sodium in patients with reduced kidney function." Chemotherapy 23 (1977): 299-308
  15. Bergan T "Pharmacokinetic comparison of oral bacampicillin and parenteral ampicillin." Antimicrob Agents Chemother 13 (1978): 971-4
  16. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc, Deerfield, IL.
  17. Granero L, Gimeno MJ, Torresmolina F, Chesajimenez J, Peris JE "Studies on the renal excretion mechanisms of cefadroxil." Drug Metab Dispos 22 (1994): 447-50
  18. Berman SJ, Boughton WH, Sugihara JG, et al "Pharmacokinetics of cefaclor in patients with end stage renal disease and during hemodialysis." Antimicrob Agents Chemother 14 (1978): 281-3
  19. Kunin CM, Finkelberg Z "Oral cephalexin and ampicillin: antimicrobial activity, recovery in urine, and persistence in blood of uremic patients." Ann Intern Med 72 (1970): 349-56
  20. Bloch R, Szwed JJ, Sloan RS, Luft FC "Pharmacokinetics of cefaclor in normal subjects and patients with chronic renal failure." Antimicrob Agents Chemother 12 (1977): 730-2
  21. Nelson JD, Reimold EW "Carbenicillin pharmacokinetics in an anephric patient." Lancet 1 (1973): 486-7
  22. Finkelstein ER, Quintiliani R, Nightingale CH "Pharmacokinetics of oral cephalosporins." J Pediatr 93 (1978): 902
  23. Braga PC, Fraschini F, Ceccarelli G, Scaglione F, Scarpazza G "Clinical pharmacokinetic evaluation of bacampicillin." Clin Ther 4 (1981): 32-42
  24. Andriole VT "Pharmacokinetics of cephalosporins in patients with normal or reduced renal function." J Infect Dis 137 (1978): s88-99
  25. "Product Information. Spectrobid (bacampicillin)." Roerig Division, New York, NY.
  26. Regamey C, Humair L "Pharmacokinetics of cephalexin in renal insufficiency." Postgrad Med J 47 Supp) (1971): 69-77
  27. Santoro J, Agarwal BN, Martinelli R, et al "Pharmacology of cefaclor in normal volunteers and patients with renal failure." Antimicrob Agents Chemother 13 (1978): 951-4
  28. Bailey RR, Gower PE, Dash CH "The effect of impairment of renal function and haemodialysis on serum and urine levels of cephalexin." Postgrad Med J 46 (1970): 60-4
  29. Ehrnebo M, Nilsson SO, Boreus LO "Pharmacokinetics of ampicillin and its prodrugs bacampicillin and pivampicillin in man." J Pharmacokinet Biopharm 7 (1979): 429-51
  30. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb, Princeton, NJ.
  31. Spyker DA, Thomas BL, Sande MA, Bolton WK "Pharmacokinetics of cefaclor and caphalexin: dosage nomograms for impaired renal function." Antimicrob Agents Chemother 14 (1978): 172-7
  32. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn, Kalamazoo, MI.
  33. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham, Philadelphia, PA.
  34. Humbert G, Leroy A, Fillastre JP, Godin M "Pharmacokinetics of cefadroxil in normal subjects and in patients with renal insufficiency." Chemotherapy 25 (1979): 189-95
  35. Yamasaku F, Tsuchida R, Usuda Y "A study of the kinetics of cephalosporins in renal impairment." Postgrad Med J Suppl (1970): 57-9
  36. Chow M, Quintiliani R, Cunha BA, et al "Pharmacokinetics of high-dose oral cephalosporins." J Clin Pharmacol 19 (1979): 185-94
  37. Dhib M, Moulin B, Leroy A, et al "Relationship between renal function and disposition of oral cefixime." Eur J Clin Pharmacol 41 (1991): 579-83
  38. "Product Information. Velosef (cephradine)." Apothecon Inc, Plainsboro, NJ.
  39. Standiford HC, Jordan MC, Kirby WM "Clinical pharmacology of carbenicillin compared with other penicillins." J Infect Dis 122 (1970): s9-13
  40. Gibaldi M, Perrier D "Drug distribution and renal failure." J Clin Pharmacol 12 (1972): 201-4
  41. "Product Information. Cedax (ceftibuten)." Schering-Plough, Liberty Corner, NJ.
  42. Gartenberg G, Meyers BR, Hirschman SZ, Srulevitch E "Pharmacokinetics of cefaclor in patients with stable renal impairment, and patients undergoing haemodialysis." J Antimicrob Chemother 5 (1979): 465-70
  43. Humbert G, Spyker DA, Fillastre JP, Leroy A "Pharmacokinetics of amoxicillin: dosage nomogram for patients with impaired renal function." Antimicrob Agents Chemother 15 (1979): 28-33
  44. "Product Information. Polymox (amoxicillin)." Bristol-Myers Squibb, Princeton, NJ.
  45. Hoffler D, Koeppe P, Corcilius M, Przyklink A "Cefpodoxime proxetil in patients with endstage renal failure on hemodialysis." Infection 18 (1990): 157-62
  46. Arancibia A, Droguett MT, Fuentes G, et al "Pharmacokinetics of amoxicillin in subjects with normal and impaired renal function." Int J Clin Pharmacol Ther Toxicol 20 (1982): 447-53
  47. Schwinghammer TL, Norden CW, Gill E "Pharmacokinetics of cephradine administered intravenously and orally to young and elderly subjects." J Clin Pharmacol 30 (1990): 893-9
  48. Hori R, Okumura K, Nihira H, et al "A new dosing regimen in renal insufficiency: application to cephalexin." Clin Pharmacol Ther 38 (1985): 290-5
  49. Yamasaku F, Tsuchida R, Usada Y "A study of the kinetics of cephalosporins in renal impairment." Postgrad Med J Suppl (1970): 57-9
  50. "Product Information. Lorabid (loracarbef)." Lilly, Eli and Company, Indianapolis, IN.
  51. Brogard JM, Pinget M, Dorner M, Lavillaureix J "Determination of cefalexin pharmacokinetics and dosage adjustments in relation to renal function." J Clin Pharmacol 15 (1975): 666-73
  52. Shyu WC, Pittman KA, Wilber RB, et al "Pharmacokinetics of cefprozil in healthy subjects and patients with renal impairment." J Clin Pharmacol 31 (1991): 362-71
  53. Andriole VT "Pharmacokinetics of cephalosporins in patients with normal or reduced renal function." J Infect Dis 137 (1978): s88-97
  54. Leroy A, Humbert G, Godin M, Fillastre JP "Pharmacokinetics of cefadroxil in patients with impaired renal function." J Antimicrob Chemother 10 (1982): 39-46
  55. "Product Information. Omnicef (cefdinir)." Parke-Davis, Morris Plains, NJ.
  56. "Product Information. Keflex (cephalexin)." Dista Products Company, Indianapolis, IN.
  57. Pommer W, Krause PH, Berg PA, et al "Acute interstitial nephritis and non-oliguric renal failure after cefaclor treatment." Klin Wochenschr 64 (1986): 290-3
  58. Kirby WM, de Maine JB, Serrill WS "Pharmacokinetics of the cephalosporins in healthy volunteers and uremic patients." Postgrad Med J 47 Suppl (1971): 41-6
  59. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company, Indianapolis, IN.
  60. Hoffman TA, Cestero R, Bullock WE "Pharmacodynamics of carbenicillin in hepatic and renal failure." Ann Intern Med 73 (1970): 173-8
  61. Kabins SA, Kelner B, Walton E, Goldstein E "Cephalexin therapy as related to renal function." Am J Med Sci 259 (1970): 133-42
  62. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb, Princeton, NJ.
  63. Neu HC "The pharmacokinetics of bacampicillin." Rev Infect Dis 3 (1981): 110-6
  64. Reisberg BE, Mandelbaum JM "Cephalexin: absorption and excretion as related to renal function and hemodialysis." Infect Immun 3 (1971): 540-3
  65. Spyker DA, Gober LL, Scheld WM, et al "Pharmacokinetics of cefaclor in renal failure: effects of multiple doses and hemodialysis." Antimicrob Agents Chemother 21 (1982): 278-81
  66. Bailey RR, Eastwood JB, Vaughan RB "The pharmacokinetics of an oral form of carbenicillin in patients with renal failure." Postgrad Med J 48 (1972): 422-5
  67. Hyslop DL "Cefaclor safety profile: a ten-year review." Clin Ther 11 Suppl A (1988): 83-94
View all 67 references
Moderate

Cefdinir/Cefixime (Includes Cefixime) ↔ Nitroprusside Tests

Moderate Potential Hazard, High plausibility

Applies to: Diabetes Mellitus

The cephalosporins, cefixime and cefdinir, have been reported to cause false-positive reactions for ketones in the urine with tests using nitroprusside, but not with tests using nitroferricyanide. Clinicians should be cognizant of this interaction when prescribing or administering either of these agents to patients with diabetes.

References

  1. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc, Baltimore, MD.
  2. "Product Information. Omnicef (cefdinir)." Parke-Davis, Morris Plains, NJ.
Moderate

Cephalosporins (Includes Cefixime) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Cases of hepatitis have been reported with the use of certain cephalosporins. Transient rise in SGOT, SGPT, and alkaline phosphatase levels have also been observed. Caution and monitoring is recommended when these agents are prescribed to patients with hepatic disorders.

Moderate

Cephalosporins (Includes Cefixime) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

Several cephalosporins have been implicated in triggering seizures, particularly in patients with renal impairment when the dosage was not reduced. If seizures occur with drug therapy, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated. Monitor patients with preexisting seizure disorders.

cefixime drug Interactions

There are 43 drug interactions with cefixime

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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