How the dose is calculated
Cefixime is dosed in mg/kg/day. Standard infections (UTI, otitis media) are dosed at 8 mg/kg/day given twice daily (BD); typhoid fever uses a higher total daily dose, also divided every 12 hours, per WHO treatment guidance.
Typical dosing by indication
| Indication | Dose | Frequency | Max |
|---|---|---|---|
| Standard | 8 mg/kg/day | every 12h (BD, 2×/day) | 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 twice-daily (BD) dosing for standard infections is straightforward to maintain compared to more frequent regimens.
- Not reliably active against Pseudomonas or most Gram-positive organisms — narrow spectrum coverage limits its use for polymicrobial or Gram-positive infections.
- Generally considered safe in pregnancy when a cephalosporin is indicated, though as with any medication in pregnancy it should only be used when clinically needed.
- 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. A common product is the 200 mg dispersible tablet (sold under brand names including Zifi 200), often used as cefixime 200 for adults and larger children.
Why is cefixime dosed differently for typhoid fever?
Typhoid fever needs a higher total daily dose to achieve adequate tissue penetration and clear Salmonella typhi reliably, compared to the standard dose used for simpler infections like UTI — both are given twice daily (BD).
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.
Is cefixime taken once daily or twice daily (BD)?
Standard-dose cefixime (8 mg/kg/day) is given twice daily (BD, every 12 hours), not once daily — enter the weight above to get the correct per-dose amount for a BD regimen.
What is cefixime and ofloxacin combination tablet used for?
Cefixime-ofloxacin is a combination product sometimes used empirically for infections where broader Gram-negative cover (including some atypical/fluoroquinolone-susceptible organisms) is wanted — it is a different, fixed-dose combination product from plain cefixime, and susceptibility/local guidance should support the choice to use a combination rather than a single agent.
Is cefixime safe in pregnancy?
Cephalosporins including cefixime are generally considered among the safer antibiotic classes in pregnancy when treatment is needed, but as with any medication in pregnancy it should only be used when clearly indicated and ideally after discussion with the treating obstetric team.
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.