How the dose is calculated
Cefixime is dosed in mg/kg/day. Standard infections (UTI, otitis media) are dosed once daily; typhoid fever uses a higher total daily dose divided every 12 hours, per WHO treatment guidance.
Typical dosing by indication
| Indication | Dose | Frequency | Max |
|---|---|---|---|
| Standard | 8 mg/kg/day | once daily | 400 mg/day |
| Typhoid fever | 15 mg/kg/day | every 12h (2×/day) | 400 mg/day |
Clinical use
- Cefixime is a third-generation oral cephalosporin with good Gram-negative coverage, making it a useful oral step-down option and an alternative for typhoid fever where fluoroquinolone resistance is a concern.
- Its once-daily dosing option for standard infections improves adherence compared to multiple-times-daily regimens.
- Not reliably active against Pseudomonas or most Gram-positive organisms — narrow spectrum coverage limits its use for polymicrobial or Gram-positive infections.
- Requires dose adjustment in significant renal impairment.
Frequently asked questions
What is cefixime used for?
Cefixime is a third-generation oral cephalosporin commonly used for urinary tract infections, otitis media, and as an oral option for typhoid fever.
Why is cefixime dosed differently for typhoid fever?
Typhoid fever needs a higher total daily dose and twice-daily dosing to achieve adequate tissue penetration and clear Salmonella typhi reliably, compared to the once-daily dose used for simpler infections like UTI.
Is cefixime effective against Pseudomonas?
No — cefixime has limited Gram-negative coverage that does not reliably include Pseudomonas aeruginosa; a different antibiotic is needed if this organism is suspected.
Can cefixime be taken once daily?
For standard infections like uncomplicated UTI or otitis media, yes — cefixime's pharmacokinetics support once-daily dosing, though typhoid fever typically uses a twice-daily higher-dose regimen.
References
- World Health Organization. Guidelines for the Management of Typhoid Fever.
- British National Formulary for Children (BNFc) — Cefixime.
- American Academy of Pediatrics Red Book — Cefixime.