When is cefixime the best choice? Clinical decisions based on the patient profile Case report
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Abstract
Cefixime, an oral third-generation cephalosporin, holds a strategic position in rational antibiotic therapy, particularly amid rising antimicrobial resistance. Its selection is driven by its unique pharmacological profile and specific patient needs, especially within the pediatric population. Key advantages:
1. Stability and spectrum – it demonstrates enhanced resistance to β-lactamases, making it effective against resistant strains of H. influenzae, M. catarrhalis, and E. coli. It provides a broad spectrum of activity against key pathogens causing urinary tract infections and respiratory tract infections.
2. Compliance – its pharmacokinetics allow for once-daily dosing, which significantly improves treatment adherence (compliance), particularly in children where an easy-to-administer suspension is available.
Optimal clinical applications (in pediatrics):
1. Step-down therapy – it is ideal for continuing intravenous treatment orally (e.g., following ceftriaxone) in cases of acute pyelonephritis in children. This approach allows for reduced hospitalization time while maintaining full efficacy.
2. Respiratory tract infections with resistance risk – it is a drug of choice for acute otitis media, especially after amoxicillin failure, due to its stability against β-lactamases.
3. Penicillin allergy – it serves as an effective alternative (e.g., in the 10-day treatment of streptococcal pharyngitis) for children with a documented penicillin allergy.
Cefixime is the optimal choice when effectiveness against βlactamase-producing pathogens and maximal dosing convenience are required.
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References
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