Recommended Cefixime Dosage for Infants
The recommended dosage of cefixime for infants is 8 mg/kg/day, typically administered in a single daily dose or divided into two doses. 1
General Dosing Guidelines
- For infants with acute otitis media, cefixime can be administered at 8 mg/kg once daily at bedtime for 10 days 1
- For respiratory and urinary tract infections in infants, cefixime at 8 mg/kg/day has been shown to achieve peak serum concentrations that exceed the minimum inhibitory concentrations of common pathogens 2
- For more severe infections like enteric fever, a higher dose of 20 mg/kg/day divided into two doses every 12 hours has been used successfully 3
Administration Considerations
- Cefixime is available as an oral suspension, making it suitable for administration to infants 2
- The drug can be given with or without food, but fasting for 2 hours before and after administration may affect absorption 2
- Peak serum concentration typically occurs between 2-8 hours after administration (mean 4.5 hours) 2
Clinical Applications
- Cefixime is effective as an alternative to other oral cephalosporins for treating common pediatric infections 4
- For Haemophilus influenzae infections, cefixime is recommended as an alternative oral therapy for step-down treatment after parenteral therapy or for mild infections 5
- The drug demonstrates good clinical efficacy against common pathogens causing acute otitis media, with cure rates comparable to amoxicillin 1
Pharmacokinetic Considerations
- The elimination half-life of cefixime in infants ranges from 2.6 to 5.6 hours, allowing for once or twice daily dosing 2
- Cerebrospinal fluid penetration occurs, with concentrations ranging from 0.02 to 0.57 μg/ml, higher in patients with meningitis 2
- The extended half-life compared to some other cephalosporins provides a more convenient dosing schedule for caregivers 4
Common Pitfalls and Precautions
- Cefixime should not be confused with cefotaxime, which requires more frequent dosing (typically every 6-8 hours) 6
- Gastrointestinal disturbances and skin rashes are the most common adverse effects, consistent with other oral cephalosporins 4
- For severe infections requiring parenteral therapy, other cephalosporins like ceftriaxone (50-100 mg/kg/day) may be more appropriate initially before transitioning to oral cefixime 5
Special Situations
- For multi-drug resistant infections, higher doses may be required, but should be determined based on susceptibility testing 3
- In cases of bacterial meningitis, cefixime should not be used as first-line therapy due to variable CSF penetration 2
- For infants with renal impairment, dosage adjustment may be necessary, though specific guidelines are limited in the pediatric population
Remember that while cefixime offers the convenience of once or twice daily dosing, selection of antimicrobial therapy should always be guided by local resistance patterns and the specific infection being treated.