Cefixime, the first oral third-generation cephalosporin introduced in
Canada, was added to the existing parenteral to oral antibiotic stepdo
wn program The agent was primarily added as an oral alternative to IV
ceftriaxone, which has a spectrum of activity similar to that of cefix
ime. Data were collected on 110 patients: 50 received cefixime and 60
received ceftriaxone during the G-month study period Cefixime was used
as a stepdown agent in 78% of its courses; however, ceftriaxone was s
tepped down to cefixime in only half the cases studied. Clinical cure
or improvement was observed in 93% of patients. An average cost avoida
nce of $347 per stepdown course was realized, projected to an annual s
aving of $27,000. Most stepdowns to cefixime met criteria for appropri
ate use; the drug was most often used to treat pleuropulmonary and bro
nchial infections.