From the Guidelines
Oral third-generation cephalosporins include cefixime, cefpodoxime, cefdinir, and ceftibuten, as stated in the study by 1. These antibiotics are part of the broader cephalosporin class but specifically offer enhanced gram-negative coverage while maintaining some gram-positive activity. Typical dosing for these medications varies, with cefixime typically given at 400mg daily or 200mg twice daily, cefpodoxime 100-200mg twice daily, cefdinir 300mg twice daily, and ceftibuten 400mg once daily, with adjustments needed for renal impairment. These medications are commonly used for:
- Respiratory tract infections
- Urinary tract infections
- Otitis media
- Certain sexually transmitted infections They work by binding to penicillin-binding proteins and disrupting bacterial cell wall synthesis, ultimately causing bacterial cell death. Compared to first and second-generation cephalosporins, third-generation agents have enhanced stability against beta-lactamase enzymes and better penetration through the outer membrane of gram-negative bacteria. However, they generally have reduced activity against gram-positive organisms like Staphylococcus aureus compared to earlier generations. Common side effects include diarrhea, nausea, and allergic reactions, with cross-reactivity possible in patients with penicillin allergies, although the risk of cross-reactivity is lower than historically reported, as noted in the study by 1. It's also worth noting that cefdinir, cefuroxime, cefpodoxime, and ceftriaxone are highly unlikely to be associated with cross-reactivity with penicillin allergy due to their distinct chemical structures, as mentioned in the study by 1. The most recent study, 1, provides recommendations on the use of antibiotics, including third-generation cephalosporins, for various infections, but does not specifically address the question of oral third-generation cephalosporins. Therefore, the information from the study by 1 remains the most relevant to the question.
From the FDA Drug Label
Cefixime is a semisynthetic, cephalosporin antibacterial for oral administration. Cefixime is an oral third generation cephalosporin 2.
- It is a semisynthetic cephalosporin antibacterial for oral administration.
- The chemical formula is C16H15N5O7S2.3H2O.
- Key points about cefixime include its mechanism of action as a cephalosporin antibacterial drug, and its pharmacokinetics, which involve approximately 40% to 50% absorption when administered orally 2.
From the Research
Definition of Oral Third Generation Cephalosporin
- An oral third generation cephalosporin is a type of antibiotic that belongs to the cephalosporin class 3, 4, 5.
- These antibiotics are characterized by their broad spectrum of antibacterial activity, particularly against gram-negative bacteria 6, 3, 4, 5.
Examples of Oral Third Generation Cephalosporins
- Cefpodoxime proxetil is an example of an oral third generation cephalosporin, which has been shown to be effective in the treatment of various bacterial infections in pediatric patients 3.
- Cefixime is another example of an oral third generation cephalosporin, which has been used to treat lower respiratory tract, ear-nose-throat, and urinary tract infections in adults 4.
- Cefdinir is also an oral third generation cephalosporin, which has been used to treat respiratory tract infections and skin and skin structure infections in adults, adolescents, and pediatric patients 5.
Characteristics of Oral Third Generation Cephalosporins
- Oral third generation cephalosporins have a broad spectrum of antibacterial activity, making them effective against a wide range of gram-positive and gram-negative bacteria 6, 3, 4, 5.
- They have good tissue penetration and are generally well tolerated, with minimal adverse effects 3, 4, 5.
- Oral third generation cephalosporins can be administered once or twice daily, depending on the specific drug and the type of infection being treated 3, 4, 5.