Cefixime Dosing for UTI
For uncomplicated urinary tract infections (UTIs), the recommended dose of cefixime is 400 mg daily, which can be administered as a single daily dose or divided into two 200 mg doses. 1
Adult Dosing
- For uncomplicated UTIs in adults, cefixime should be administered at 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
- For patients with normal renal function (creatinine clearance ≥60 mL/min), no dose adjustment is required 1
Renal Impairment Dosing
- For patients with moderate renal impairment (creatinine clearance 21-59 mL/min), the dose should be reduced to approximately 65% of the normal dose 1
- For patients with severe renal impairment (creatinine clearance ≤20 mL/min) or on continuous peritoneal dialysis, the dose should be reduced to approximately 43% of the normal dose 1
- Neither hemodialysis nor peritoneal dialysis removes significant amounts of cefixime from the body 1
Pediatric Dosing
- For pediatric patients 6 months or older, the recommended dose is 8 mg/kg/day 1
- This may be administered as a single daily dose or divided into two doses of 4 mg/kg every 12 hours 1
- Children weighing more than 45 kg or older than 12 years should receive the adult dose of 400 mg daily 1
Duration of Therapy
- For uncomplicated UTIs, clinical studies have shown high efficacy rates with cefixime treatment 2, 3
- Studies have demonstrated clinical cure rates of 96-98% for uncomplicated cystitis with cefixime treatment 2, 3
- The typical duration for uncomplicated UTIs is 7-10 days, though specific duration is not explicitly stated in the FDA label for UTIs 4
Clinical Considerations
- Cefixime is particularly active against many Enterobacteriaceae, including Escherichia coli, which is the most common cause of UTIs 4
- The FDA label specifically indicates cefixime for treatment of uncomplicated UTIs caused by susceptible isolates of Escherichia coli and Proteus mirabilis 1
- Some studies suggest that dividing the daily dose into two 200 mg doses may result in fewer gastrointestinal adverse effects compared to a single 400 mg dose 5
Common Side Effects
- The most frequently reported adverse effects are diarrhea and stool changes, which are usually mild to moderate in severity and transient 4
- These adverse effects typically occur in the first few days of treatment 4
- Subjective adverse reactions such as generalized pruritus and upper gastrointestinal discomfort have been reported in approximately 1.7% of patients 2
Monitoring
- Urine culture and susceptibility testing should be performed before starting therapy to guide appropriate treatment 6
- If symptoms persist after 72 hours of treatment, reevaluation of the diagnosis and consideration of imaging may be necessary 6
Remember that cefixime should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the development of drug-resistant bacteria 1.