Cefixime Dosing in Neonates
Cefixime is not recommended for use in neonates, as there is no established dosing regimen or safety data for this population, and it should not be used as first-line therapy in this age group. 1
Key Clinical Considerations
Why Cefixime is Inappropriate for Neonates
Lack of established dosing: The available evidence does not provide specific dosing recommendations for cefixime syrup in neonates, and the drug is not routinely used in this population 1
Severe infections require parenteral therapy: Neonatal infections typically require parenteral antibiotics initially, and cefixime is only appropriate as step-down oral therapy after parenteral treatment for mild infections in older infants and children 1
Appropriate Alternatives for Neonatal Infections
For severe neonatal infections: Use parenteral cephalosporins such as ceftriaxone (50-100 mg/kg/day) or cefotaxime as first-line therapy 1
Cefotaxime dosing in neonates: A model-based regimen of 50 mg/kg administered twice to four times daily (depending on gestational age and postnatal age) has been established for neonatal use 2
Common Pitfalls to Avoid
Do not use oral cephalosporins for neonatal sepsis: Neonates with suspected bacterial infections require parenteral antibiotics due to the severity of potential infections and unpredictable oral absorption 1
Renal function considerations: If cefixime were to be considered in older infants with renal impairment, dosage adjustment would be necessary, though specific pediatric guidelines are limited 1
When Cefixime May Be Considered (Not in Neonates)
- Cefixime is only appropriate as an alternative oral therapy for step-down treatment in older infants and children after initial parenteral therapy for infections such as Haemophilus influenzae 1