CEFIXIME - A REVIEW OF ITS THERAPEUTIC EFFICACY IN LOWER RESPIRATORY-TRACT INFECTIONS

Cefixime is an orally active third generation cephalosporin with in vi tro antibacterial activity against most important lower respiratory pa thogens. The drug is active against Haemophilus influenzae, Moraxella catarrhalis and penicillin-susceptible Streptococcus pneumoniae but no t Staphylococcus aureus. Cefixime has a long elimination half-life (3 hours compared with 0.5 hours for cefaclor and 1.5 hours for cefalexin ), which allows once daily administration. Several trials have establi shed the clinical efficacy of the drug in patients with lower respirat ory tract infection (LRTI). In comparative studies cefixime had simila r efficacy to amoxicillin +/- clavulanic acid, cefaclor; cefalexin, ce furoxime axetil and clarithromycin. Trials evaluating the efficacy of cefixime as the oral component of intravenous to oral switch therapy h ave produced promising preliminary results although further carefully designed trials are needed in this area. As with certain other drugs o f its class, gastrointestinal disturbances are the most frequently rep orted adverse events in patients taking cefixime and cases of pseudome mbranous colitis have been reported. Thus, cefixime is an effective tr eatment for mild to moderate LRTI and may have a role as the oral comp onent of intravenous to oral switch therapy although further well desi gned studies are needed to confirm initial favourable results in this important emerging area of antibacterial therapy.