Is cefixime (Cefixime) effective against Escherichia coli (E. coli) infections?

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Last updated: May 23, 2025View editorial policy

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From the FDA Drug Label

Cefixime has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections [see Indications and Usage (1)] Gram-negative Bacteria Escherichia coli Haemophilus influenzae Moraxella catarrhalis Neisseria gonorrhoeae Proteus mirabilis

Cefixime is effective against Escherichia coli as it has been shown to be active against most isolates of this microorganism, both in vitro and in clinical infections 1.

  • Key points:
    • Cefixime is indicated for the treatment of uncomplicated urinary tract infections caused by susceptible isolates of Escherichia coli 1.
    • The drug has been shown to be active against most isolates of Escherichia coli in vitro and in clinical infections 1.

From the Research

Cefixime is not the most effective option for treating E. coli infections due to increasing resistance rates, and its use should be guided by local susceptibility patterns and culture and sensitivity testing, as indicated by the most recent study 2.

Key Points to Consider

  • Cefixime has a broad spectrum of antibacterial activity, but its effectiveness against E. coli varies based on local resistance patterns 3, 2.
  • The typical adult dose of cefixime is 400mg once daily for 7-14 days, depending on infection severity, but this may not be sufficient for severe infections or those caused by resistant strains 4, 5.
  • Cefixime works by inhibiting bacterial cell wall synthesis, causing bacterial cell death, but some E. coli strains have developed resistance through extended-spectrum beta-lactamase (ESBL) production 6.
  • Common side effects of cefixime include diarrhea, abdominal pain, and nausea, and patients should complete the full course of antibiotics even if symptoms improve before completion to prevent resistance development 3, 5.

Important Considerations

  • Local susceptibility patterns and culture and sensitivity testing should guide the use of cefixime for treating E. coli infections, especially in severe cases or when resistance is suspected 2, 6.
  • Cefixime may not be effective against ESBL-producing E. coli strains, and alternative antibiotics should be considered in these cases 6.
  • The incidence of resistant organisms reported during clinical trials with cefixime was low, but this may not reflect current resistance rates, and local surveillance data should be consulted to inform treatment decisions 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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