Cefixime
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Non-proprietary name | Cefixime | |||||||||||||||||||||
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Molecular formula |
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Brief description |
white, odorless powder (cefixime trihydrate) |
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Drug information | ||||||||||||||||||||||
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Drug class |
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Mechanism of action |
Inhibition of bacterial cell wall synthesis |
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properties | ||||||||||||||||||||||
Molar mass | ||||||||||||||||||||||
Physical state |
firmly |
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Melting point |
218–225 ° C (cefixime trihydrate) |
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Toxicological data | ||||||||||||||||||||||
As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions . |
Cefixime is a semisynthetic broad spectrum antibiotic from the group of β-lactam antibiotics and the third generation of cephalosporins . It is orally administered.
Spectrum of activity
Cefixime has a bactericidal effect against gram- positive and gram- negative bacteria .
In general, Cefixime is effective against the following pathogens:
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Streptococcus agalactiae
- Haemophilus influenzae
- Haemophilus parainfluenzae
- Moraxella catarrhalis
- Neisseria gonorrhoeae
- Escherichia coli
- Proteus mirabilis
- Proteus vulgaris
- Types of Proteus (including indole-positive species)
- Klebsiella pneumoniae
- Klebsiella oxytoca
- Types of Enterobacter
- Pasteurella multocida
- Types of Providencia
- Types of Salmonella
- Serratia marcescens
- Types of Shigella
- Citrobacter amalonaticus
- Citrobacter diversus
Staphylococci (e.g. Staphylococcus aureus ) are resistant to cefixime .
pharmacology
Pharmacodynamics
Many pathogens are resistant to penicillins and some cephalosporins . These may be susceptible to cefixime as cefixime in the presence of very stable β-lactamase - enzymes is.
Mechanism of action
Cefixime inhibits bacterial cell wall synthesis . It prevents growing, dividing cells crosslinking of certain building blocks, so the out murein existing cell wall bursts and the bacteria die.
Dose-response relationship
Cefixime has a wide therapeutic range .
Ingesting large amounts of cefixime can lead to an overdose . Signs of this include symptoms such as blood in the urine , diarrhea , nausea , upper abdominal pain, and vomiting .
Pharmacokinetics
The absorption of cefixime is not food intake affected.
The half-life ( half-life ) of cefixime is 3–4 hours, but under certain circumstances it can increase to 9 hours. In patients with severe renal impairment (5–20 milliliters / minute creatinine clearance ), the half-life can increase to 11.5 hours.
The metabolism of cefixime takes place via the liver . Approximately 50 % of the absorbed dose is excreted unchanged in the urine within 24 hours .
Indications
Cefixime is used for acute and chronic bacterial infections with cefixime-sensitive bacteria such as streptococci . Which includes:
- Upper and lower respiratory infections
- lung infection
- Inflammation of the mouth and throat
These infections also include ear, nose and throat infections such as
Also, cefixime can be used to treat
- Venereal diseases (such as gonorrhea )
- Skin infections
- Infections of the urinary tract such as kidney infections and urinary tract infections
- Infections of the biliary tract
can be used.
Contraindications and restrictions on use
Cefixime must not be used if you have had severe hypersensitivity reactions to the drug or to other β-lactam antibiotics in the past. Cefixime is also contraindicated in premature and newborn babies (less than 28 days of age).
Cefixime should be used with caution
- in patients with any hypersensitivity or allergy to penicillin and other β-lactam antibiotics , as a cross-allergy may exist,
- in patients with existing or a history of severe allergies or asthma ,
- if there is severe renal impairment (corresponding to a creatinine clearance of less than 10 milliliters / minute).
Due to the lack of teratogenic effects, cefixime can be used during pregnancy and breastfeeding .
Drug interactions
Cefixime can reduce the nephrotoxicity of certain drugs , e.g. B. aminoglycosides , and increase the risk of bleeding with simultaneous therapy with anticoagulants or platelet aggregation inhibitors .
When nifedipine is administered at the same time , the bioavailability of cefixime is increased by approx. 70%.
After using Cefixime, urine test methods based on reduction may be false positive, but not when using enzymatic methods.
Side effects
The most common side effects affect the gastrointestinal tract and manifest themselves in soft stools or even diarrhea (in 1% to 10% of those treated).
Occasionally, headaches and rashes occur.
Rarely (less than 0.1% of those treated) have hypersensitivity reactions of all degrees of severity, including anaphylactic shock . Hypersensitivity reactions have also been observed after oral administration of cephalosporins , albeit much less frequently than after intravenous or intramuscular administration.
Very rare undesirable effects (less than 1 in 10,000 patients treated) are changes in the blood count , such as: B. Decrease in the total number of white blood cells ( leukopenia ); a serious decrease in certain types of white blood cells in the blood ( agranulocytosis ) that may develop within hours ; severe decrease in all blood cells ( pancytopenia ) or decrease in the number of platelets ( thrombocytopenia ); Decrease in the number of red blood cells . Also very rare are blood clotting disorders and serum sickness- like reactions, liver inflammation , severe skin changes ( erythema exudativum multiforme and Lyell's syndrome ) and antibiotic-associated colon inflammation characterized by severe and persistent diarrhea .
Trade names
Cefixime is processed in finished medicinal products as cefixime trihydrate (cefixime 3H 2 O) and is available in the form of tablets , film-coated tablets , drinking tablets , dry juice and granules for the preparation of a suspension in the doses 200 mg and 400 mg for tablets and 100 mg / 5 ml for juices and suspensions in trade.
Suprax (D), InfectoOptiCef (D), Cephoral (D, CH), Uro-Cephoral (D), Aerocef (A), Tricef (A), some generics (D)
literature
- Jörg Martin, Peter Lehle, Wolfgang Ilg: Finished medicinal products . 6th edition. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart 2002, ISBN 3-8047-1760-8 .
- Doris Grimm: chemistry . 7th edition. Deutscher Apotheker Verlag, Stuttgart 2003, ISBN 3-7692-3083-3 .
- Product information Suprax® 400 mg film-coated tablets from Astellas Pharma Europe Ltd. , accessed July 6, 2011.
Web links
- Entry on cefixime in Pharmawiki
Individual evidence
- ↑ a b Data sheet Cefixime trihydrate from Sequoia Research Products, accessed on July 6, 2011.
- ↑ Entry on cefixime in Pharmawiki , accessed on July 6, 2011.
- ↑ a b Data sheet Cefixime trihydrate from Sigma-Aldrich , accessed on May 18, 2017 ( PDF ).
- ↑ a b c d e f g h Entry on Cefixime in the ChemIDplus database of the United States National Library of Medicine (NLM), accessed on July 6, 2011.
- ^ Marianne Abele-Horn: Antimicrobial Therapy. Decision support for the treatment and prophylaxis of infectious diseases. With the collaboration of Werner Heinz, Hartwig Klinker, Johann Schurz and August Stich, 2nd, revised and expanded edition. Peter Wiehl, Marburg 2009, ISBN 978-3-927219-14-4 , p. 340.
- ↑ External identifiers or database links for cefixime trihydrate : CAS number: 125110-14-7, EC number: 635-033-5, ECHA InfoCard: 100.162.959 , PubChem : 5491577 , ChemSpider : 4590586 , DrugBank : DBSALT001818 , Wikidata : Q60025382 .