| Description | Bacteria possess a cell wall comprising a glycopeptide polymer commonly known as peptidoglycan, which is synthesized and remodelled through the action of a family of enzymes known as "penicillin-binding proteins" (PBPs).[A232920] β-lactam antibiotics, including cephalosporins, are PBP inhibitors that, through inhibition of essential PBPs, result in impaired cell wall homeostasis, loss of cell integrity, and ultimately bacterial cell death.[A232920, A232925, A232930] Cefixime is a broad-spectrum antibiotic and an orally-active third-generation semisynthetic cephalosporin.[A262894,A263011 ,L49293] Cephalosporins are beta-lactam antibiotics and can be used to treat gram-positive and gram-negative bacterial infections which include conditions such as skin infections, resistant bacteria, and meningitis.[A262995] Examples of third-generation cephalosporins are [ceftriaxone], [cefotaxime], and [ceftazidime].[A262995] Third-generation cephalosporins are often a first-line therapy against certain bacterial infections.[A263026] However, cefixime is not recommended as a first-line of treatment for uncomplicated urogenital, anorectal, or pharyngeal gonorrhea because cefixime does not provide the same bactericidal effect as [ceftriaxone].[L49686,A263021] Generally, cefixime is used to treat uurinary tract infections, middle ear infections, pharyngitis, tonsillitis, exacerbations of chronic bronchitis, and uncomplicated gonorrhea.[L49293] The beta-lactam ring of cefixime inhibits bacterial cell wall synthesis by binding to the penicillin-binding proteins which will then result in lysis.[A262995,A262945,A262950] Specifically, cephalosporins inhibit penicillin-sensitive enzymes responsible for the final 3D structure of the bacterial cell wall which in turn inhibit bacterial cell wall peptidoglycan synthesis.[T894, T322] Additionally, third-generation cephalosporins have been shown to have more stability in the presence of beta-lactamases compared to first- and second-generation cephalosporins.[A263031] Cefixime was first approved in the United States in 1986.[L49293] |
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| Indication | Cefixime is indicated for the treatment of uncomplicated urinary tract infections caused by _Escherichia coli_ and _Proteus mirabilis_, otitis media caused by _Haemophilus influenzae_, _Moraxella catarrhalis_, and _Streptococcus pyogenes_, pharyngitis and tonsillitis caused by _Streptococcus pyogenes_, acute exacerbations of chronic bronchitis caused by _Streptococcus pneumoniae_ and _Haemophilus influenzae_, and uncomplicated gonorrhea (cervical/urethral) caused by _Neisseria gonorrhoeae_ (penicillinase-and non-penicillinase-producing isolates).[L49293] |
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