Indications: Fix-A is an orally active cephalosporin antibiotic with marked in‑vitro bactericidal activity against a wide variety of Gram‑positive and Gram‑negative organisms. It is indicated for the treatment of acute infections caused by susceptible microorganisms, including:

Upper respiratory tract infections (URTI) such as otitis media and other URTI where the causative organism is resistant to commonly used antibiotics or where treatment failure may carry significant risk.
Lower respiratory tract infections such as bronchitis.
Urinary tract infections such as cystitis, cystourethritis, pyelonephritis.

Clinical efficacy has been demonstrated against pathogens including Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella species, Haemophilus influenzae (beta‑lactamase positive and negative), Moraxella catarrhalis (beta‑lactamase positive and negative), and Enterobacter species. Fix‑A is highly stable in the presence of beta‑lactamase enzymes.

Pharmacology: Cefixime is a third‑generation semi‑synthetic cephalosporin antibiotic for oral administration. It is bactericidal against a broad spectrum of Gram‑positive and Gram‑negative bacteria at plasma concentrations usually achieved. It acts by interfering with bacterial cell wall synthesis. Cefixime is highly stable in the presence of beta‑lactamase enzymes, making it effective against organisms resistant to penicillins and some cephalosporins. Absorption is about 40–50%, whether administered with or without food.

Dosage & Administration:

Usual course: 7 days, may be extended up to 14 days if required.
Adults & children over 10 years: 200–400 mg daily, either as a single dose or in two divided doses.
Elderly: Same as adults, but renal function should be assessed and dosage adjusted in severe impairment.
Children: 8 mg/kg/day as a single dose or in two divided doses.
- Up to 1 year: 3.75 ml daily
- 1–4 years: 5 ml daily
- 5–10 years: 10 ml daily
Typhoid fever: 5 mg/kg twice daily for 10–14 days.
Children >50 kg or >10 years: Use adult dose.
Not established in children <6 months.
Renal impairment:
- CrCl ≥20 ml/min: normal dose.
- CrCl <20 ml/min: do not exceed 200 mg once daily.
- Hemodialysis/peritoneal dialysis: same as CrCl <20 ml/min.

Interactions: Like other cephalosporins, increases in prothrombin time have been noted in some patients. Caution should be exercised in those receiving anticoagulant therapy.

Contraindications: Patients with known hypersensitivity to cephalosporin antibiotics.

Side Effects: Generally well tolerated. Most adverse reactions are mild and self‑limiting.

Gastrointestinal: diarrhea (more common at higher doses), stool changes, nausea, abdominal pain, dyspepsia, vomiting, flatulence, pseudomembranous colitis.
CNS: headache, dizziness.
Hypersensitivity: rash, pruritus, urticaria, drug fever, arthralgia.
Hematology: thrombocytopenia, leukopenia, eosinophilia.
Biochemistry: mild transient changes in liver and renal function tests.
Miscellaneous: genital pruritus, vaginitis.

Pregnancy & Lactation: There are no adequate and well‑controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. It is not known whether cefixime is excreted in human milk. Caution should be exercised when cefixime is administered to a nursing woman.