What is Cefixime?
Cefixime is a third-generation oral cephalosporin antibiotic used to treat a range of bacterial infections, with a particular role in sexual health for the management of gonorrhoea caused by Neisseria gonorrhoeae. It is listed on the WHO Model List of Essential Medicines and has been included in European STI treatment guidelines.
Cefixime offers broad-spectrum bactericidal activity against gram-negative organisms and is valued for its oral bioavailability, making it accessible without requiring an injection. However, increasing antibiotic resistance in Neisseria gonorrhoeae has led guidelines to shift emphasis toward injectable ceftriaxone as the preferred first-line option.
How does Cefixime work?
Cefixime is a beta-lactam antibiotic that kills bacteria by inhibiting cell wall synthesis. It binds to penicillin-binding proteins (PBPs) on the bacterial surface, blocking the final stage of peptidoglycan cross-linking that gives bacterial cell walls their structural rigidity. Without an intact cell wall, bacteria lyse and die.
Compared to first- and second-generation cephalosporins, cefixime has enhanced stability against many beta-lactamase enzymes produced by gram-negative bacteria, giving it broader gram-negative coverage. Key properties include:
- Oral administration: Unlike many third-generation cephalosporins, cefixime is well absorbed orally (40–50% bioavailability)
- Gram-negative coverage: Strong activity against Neisseria gonorrhoeae, Haemophilus influenzae, and E. coli
- Renal excretion: Primarily eliminated unchanged by the kidneys
- Long half-life: Allows once-daily dosing in many indications
Who is Cefixime for?
Cefixime is indicated for the treatment of infections caused by susceptible bacteria. In a sexual health context, it is relevant for:
- Uncomplicated gonorrhoea: Urethral, cervical, and rectal gonorrhoea in adults when ceftriaxone is not available or appropriate, and local susceptibility data support use
- Urinary tract infections (UTIs): Caused by susceptible gram-negative organisms
- Upper respiratory tract infections: Though less relevant in sexual health contexts
Current gonorrhoea treatment guidance: European STI guidelines and the WHO recommend confirming antibiotic susceptibility before using oral agents for gonorrhoea, as multi-drug resistant strains are increasingly prevalent. Always follow the current guidance provided by the treating doctor.
Cefixime is not effective against:
- Viral infections (herpes, HPV, HIV)
- Fungal infections
- Chlamydia trachomatis (requires different antibiotic classes such as azithromycin or doxycycline)
Posología
| Indicación | Dosis | Duración |
|---|---|---|
| Uncomplicated gonorrhoea | 400 mg single dose | Once |
| Uncomplicated UTI | 200 mg twice daily or 400 mg once daily | 7 days |
| Complicated UTI | 400 mg once daily | Up to 14 days |
Cefixime is available as tablets (200 mg, 400 mg) and oral suspension. It can be taken with or without food. If nausea is an issue, taking it with food may help.
Note for gonorrhoea treatment: Current European guidelines recommend that gonorrhoea treatment should ideally be confirmed with culture and sensitivity testing. Cefixime should only be used for gonorrhoea when local resistance patterns and test results support its use, and when followed by a test of cure.
Efectos secundarios
Efectos secundarios frecuentes (afectan a entre 1 y 10 de cada 100 personas)
- Diarrhoea
- Nausea
- Abdominal pain
- Loose stools
Efectos secundarios poco frecuentes
- Vomiting
- Headache
- Dizziness
- Flatulence
- Dyspepsia (indigestion)
Efectos secundarios graves (raros)
- Hypersensitivity reactions: From mild urticaria (hives) to anaphylaxis — seek emergency help immediately if this occurs
- Clostridioides difficile colitis: Severe, persistent diarrhoea possibly with blood — discontinue and seek medical attention
- Stevens-Johnson syndrome / toxic epidermal necrolysis: Rare serious skin reactions
- Haematological effects: Including neutropenia, thrombocytopenia, and haemolytic anaemia with prolonged use
Cefixime vs other gonorrhoea treatments
| Tratamiento | Vía | Notas |
|---|---|---|
| Ceftriaxone | IM injection | Preferred first-line per EU/WHO guidelines; high efficacy |
| Cefixime | Oral tablet | Second-line oral option; resistance increasing |
| Azithromycin (Zithromax) | Oral tablet | Formerly combined with cefixime; limited monotherapy role now |
| Spectinomycin | IM injection | Used when other agents are contraindicated |
Clinical context: The WHO and European STI guidelines currently recommend injectable ceftriaxone (500 mg or 1 g IM) as the preferred treatment for gonorrhoea due to the global spread of reduced susceptibility to cefixime. The use of oral cefixime for gonorrhoea should be guided by sensitivity testing and prescribed by a doctor with awareness of current local resistance patterns.
How to access Cefixime online in Europe
Cefixime es un medicamento sujeto a prescripción médica en todos los estados miembros de la UE. No puede dispensarse legalmente sin una receta válida de un profesional médico autorizado.
Prescrivia opera como intermediario tecnológico: no prescribimos medicamentos, no empleamos médicos ni vendemos medicamentos. Nuestra plataforma conecta a los pacientes con médicos independientes registrados en la UE que pueden realizar evaluaciones de salud en línea confidenciales.
El proceso:
- Complete una evaluación de salud: Provide details of your symptoms, sexual history, any prior STI testing, and medications or allergies.
- Revisión médica: Un médico independiente registrado en la UE revisa su evaluación. If cefixime is clinically appropriate based on your circumstances, they may issue a prescription.
- Dispensación en farmacia: La receta se envía a una farmacia asociada autorizada de la UE para su dispensación y entrega directa.
Importante: Prescrivia does not guarantee that a prescription will be issued. For gonorrhoea, testing and culture are strongly recommended. All prescribing decisions are made independently by qualified medical professionals.
Información importante de seguridad
Informe a su médico antes de taking Cefixime si usted:
- Have a known allergy to cephalosporins or penicillins
- Have kidney disease (dose reduction may be required)
- Are pregnant or breastfeeding
- Have a history of gastrointestinal disease, especially colitis
- Are taking any other medicines, including anticoagulants (cefixime may interact with warfarin)
Prueba de curación: After treatment for gonorrhoea, a test of cure (repeat testing 1–2 weeks after treatment) is strongly recommended to confirm successful eradication of the infection, as per European STI guidelines.
Notificación a la pareja: If diagnosed with gonorrhoea or another STI, sexual partners should be informed and offered testing and treatment. This is an important step in preventing reinfection and reducing transmission.
Fuentes
La información médica de esta página se basa en las siguientes fuentes:
- World Health Organization (WHO). WHO Guidelines for the Treatment of Neisseria gonorrhoeae. 2016. who.int
- European STI Guidelines Editorial Board. 2021 European guideline on the diagnosis and treatment of gonorrhoea in adults. Journal of the European Academy of Dermatology and Venereology.
- World Health Organization (WHO). WHO Model List of Essential Medicines. 22nd edition, 2021.
- European Medicines Agency (EMA). Cefixime — Summary of Product Characteristics. Disponible en: ema.europa.eu
Este contenido se revisa periódicamente para reflejar las directrices clínicas actualizadas. Se proporciona únicamente con fines informativos y no constituye asesoramiento médico. Consulte siempre a un profesional sanitario cualificado para obtener asesoramiento relevante para sus circunstancias de salud individuales.
Frequently asked questions
- What is Cefixime used for in sexual health?
- Cefixime is a third-generation cephalosporin antibiotic primarily used in sexual health for the treatment of uncomplicated gonorrhoea (Neisseria gonorrhoeae infection). European and WHO guidelines have historically included cefixime as a component of gonorrhoea treatment regimens, though current guidance increasingly favours ceftriaxone (injectable) due to growing oral cefixime resistance.
- Is Cefixime still recommended for gonorrhoea in Europe?
- European guidelines from the European STI Guidelines Editorial Board recommend injectable ceftriaxone as the preferred first-line treatment for gonorrhoea. Oral cefixime may still be used in specific clinical scenarios when ceftriaxone is not available or is contraindicated, based on local susceptibility testing. Your doctor will advise on the most appropriate treatment.
- How is Cefixime taken?
- For uncomplicated gonorrhoea, cefixime is typically given as a single oral dose of 400 mg. For other indications such as urinary tract infections, it may be prescribed as 200–400 mg once daily or 100–200 mg twice daily for 7 to 14 days, depending on the infection and doctor's assessment.
- Can I be allergic to Cefixime?
- Yes. Cefixime is a cephalosporin antibiotic, and cephalosporin allergy is possible. There is also a small degree of cross-reactivity with penicillin allergy (approximately 1–2%). If you have a known penicillin or cephalosporin allergy, inform your doctor before starting treatment.
- Can I get Cefixime online in Europe?
- Cefixime es un medicamento sujeto a prescripción médica en todos los estados miembros de la UE. Puede acceder a it through online intermediary platforms that connect you with independent EU-registered doctors who can conduct a confidential health assessment and, if appropriate, issue a prescription.
Tratamientos
Prescrivia es únicamente una plataforma intermediaria. No prestamos servicios médicos, no prescribimos tratamientos ni dispensamos medicamentos. Todas las decisiones médicas son tomadas por médicos independientes registrados en la UE. Todos los medicamentos son dispensados por farmacias autorizadas de la UE. Esta plataforma facilita la conexión entre pacientes y profesionales sanitarios.