Cefixime Treatment Recommendations

Introduction to Cefixime

• The Centers for Disease Control and Prevention recommends against using cefixime as first-line therapy for gonorrhea due to rising resistance 1

Uncomplicated Gonorrhea Treatment

• Cefixime provides lower and less sustained bactericidal levels than ceftriaxone 125 mg IM, with only 97.1-97.4% cure rates for urogenital/anorectal gonorrhea compared to 99.1% for ceftriaxone 2, 3, 4
• Cefixime has limited efficacy for pharyngeal gonorrhea 1

Enteric Fever Treatment

• The World Health Organization recommends 8 mg/kg/day as a single daily dose for children >28 days old, and 400 mg orally once daily for adults, with a treatment duration of 7-14 days 5
• Cefixime showed significantly more treatment failures and longer fever duration compared to ofloxacin in randomized trials of typhoid fever 5

Comparative Efficacy and Resistance

• Cefixime provides lower and less sustained bactericidal levels than injectable ceftriaxone at equivalent antimicrobial spectrum 2, 6
• Rising minimum inhibitory concentrations (MICs) to cefixime have been documented, particularly in the Western United States and among men who have sex with men 1