Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Third-generation oral cephalosporin Pregnancy: No adequate and well-controlled studies in pregnant women. Should not be used in pregnancy or in nursing mothers unless considered essential by the physician.

Cefixime

Brand names: Suprax

Cefixime is a third-generation oral cephalosporin antibacterial used for susceptible Gram-negative infections, including uncomplicated urinary tract infections and, where indicated, gonorrhoea.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 200 to 400 mg daily
Route: Oral
Frequency: Once daily as a single dose, or in two divided doses
Adults and children over 10 years or weighing more than 50 kg: 200 to 400 mg daily according to severity of infection. Usual course of treatment is 7 days, continued up to 14 days if required. Absorption is not significantly modified by food. Elderly may be given the same dose as adults.

Paediatric dose

Route: Oral
UK SPC (Suprax 200 mg Tablets): tablets not recommended for children under 10 years; safety and efficacy not established in children under 6 months. A per-kg paediatric dose is NOT stated in this UK tablet SPC. For reference, US labelling (verify vs UK SPC) states 8 mg/kg/day of the oral suspension for children 6 months and older, as a single daily dose or 4 mg/kg every 12 hours; children over 45 kg or older than 12 years should be treated with the adult dose.

Dose adjustments

Renal

Normal dose and schedule for creatinine clearance 20 mL/min or greater. If creatinine clearance is less than 20 mL/min, a dose of 200 mg once daily should not be exceeded. Patients on chronic ambulatory peritoneal dialysis or haemodialysis follow the same recommendation as for CrCL less than 20 mL/min.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to cephalosporin antibiotics or to any of the excipients

Side effects

  • Diarrhoea (more commonly associated with higher doses)
  • Abdominal pain
  • Nausea
  • Vomiting
  • Headache

Interactions

  • Carbamazepine: elevated carbamazepine levels reported when co-administered (drug monitoring may assist) - from US labelling
  • Warfarin and anticoagulants: increased prothrombin time, with or without clinical bleeding, reported - from US labelling
  • May cause false-positive urinary glucose (Clinitest, Benedict's or Fehling's solution), false-positive urine ketones, and false-positive direct Coombs test - from US labelling

Clinical monograph

How it works

It is a beta-lactam that binds penicillin-binding proteins, inhibiting bacterial cell-wall peptidoglycan synthesis and producing a bactericidal effect.

Prescribing in practice

  • Avoid in patients with a history of immediate (anaphylactic) hypersensitivity to penicillins or other beta-lactams owing to the risk of cross-reactivity.
  • Activity is predominantly against Gram-negative organisms; it has poor activity against staphylococci, so it is unsuitable for suspected staphylococcal infection.
  • Dose adjustment is required in significant renal impairment, in line with the SPC.

Monitoring

Routine laboratory monitoring is not generally required for short courses, but renal function should inform dosing and clinical response should be reviewed.

Counselling the patient

  • Complete the full prescribed course even if you feel better.
  • Report any rash, facial swelling or breathing difficulty, or severe or persistent diarrhoea.

Evidence & guidelines

Use is supported by NICE and UK antimicrobial guidance for specific susceptible infections rather than as a first-line broad-spectrum agent.

Reference: BASHH gonorrhoea; UKHSA; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways