Recommended Dosage of Cefixime for Urinary Tract Infections
For the treatment of urinary tract infections, cefixime should be administered at a dose of 400 mg daily for adults, which can be given as a single daily dose or divided into two 200 mg doses. 1
Adult Dosing
Uncomplicated UTI
- 400 mg daily, which may be given as a single dose or divided into two 200 mg doses 1
- The medication can be administered without regard to food 1
- When treating uncomplicated urinary tract infections, cefixime has shown an overall clinical effectiveness rate of 98% 2
- Dividing the daily dose into two 200 mg doses may reduce gastrointestinal side effects compared to a single 400 mg dose 3
Special Populations
Renal Impairment
- For patients with creatinine clearance of 60 mL/min or greater: normal dose (400 mg daily) 1
- For patients with creatinine clearance of 21-59 mL/min: reduced dose required 1
- For patients with creatinine clearance of 20 mL/min or less or on hemodialysis/peritoneal dialysis: further dose reduction required 1
Pediatric Dosing
- For children 6 months or older: 8 mg/kg/day of the suspension 1
- This may be administered as a single daily dose or divided into two doses (4 mg/kg every 12 hours) 1
- Children weighing more than 45 kg or older than 12 years should receive the adult dose 1
Duration of Treatment
- Standard duration for uncomplicated UTIs is typically 7-10 days 4
- For infections due to Streptococcus pyogenes, treatment should be administered for at least 10 days 1
Clinical Efficacy
- Cefixime has demonstrated high efficacy in treating uncomplicated UTIs with clinical cure rates of 92-96% 5
- Bacteriological cure rates of 89-97.5% have been reported in clinical trials 5
- For complicated UTIs, the clinical effectiveness rate is lower at approximately 57% 2
Considerations and Precautions
- Cefixime has an antimicrobial spectrum similar to that of ceftriaxone but does not provide as high or sustained bactericidal levels 6
- The advantage of cefixime over injectable cephalosporins is that it can be administered orally 6
- Cefixime is particularly active against many Enterobacteriaceae, which are common causative organisms in UTIs 4
- The most common adverse effects are gastrointestinal disturbances (diarrhea and stool changes), which are usually mild to moderate and transient 4
- Due to its broad spectrum of activity against common uropathogens, cefixime can be initiated prior to sensitivity testing in uncomplicated UTIs 3
Comparative Efficacy
- Clinical trials indicate that cefixime 400 mg daily is comparable in efficacy to co-trimoxazole or amoxicillin in treating acute uncomplicated UTIs 4
- Cefixime is effective against many beta-lactamase producing organisms that may cause UTIs 4
Remember that while cefixime is effective for most uncomplicated UTIs, it has limited activity against certain pathogens like Pseudomonas aeruginosa and some gram-positive organisms, which may be relevant in complicated UTIs 4, 3.