O que é 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 tratamento guidelines.
Cefixime offers broad-spectrum bactericidal activity against gram-negative organisms and is valued for its oral bioavailability, making it accessible without requiring an injeção. However, increasing antibiotic resistance in Neisseria gonorrhoeae has led guidelines to shift emphasis toward injectable ceftriaxone as the preferred first-line option.
Como funciona 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
Para quem é Cefixime for?
Cefixime is indicated for the tratamento 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 tratamento 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 médico.
Cefixime is not effective against:
- Viral infections (herpes, HPV, HIV)
- Fungal infections
- Chlamydia trachomatis (requires different antibiotic classes such as azithromycin or doxycycline)
Dosagem
| Indication | Dose | Duration |
|---|---|---|
| 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 comprimidos (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 tratamento: Current European guidelines recommend that gonorrhoea tratamento should ideally be confirmed with culture and sensitivity testing. Cefixime should only be utilizado para gonorrhoea when local resistance patterns and test results support its use, and when followed by a test of cure.
Efeitos secundários
Efeitos secundários comuns (afetando 1 a 10 em 100 pessoas)
- Diarrhoea
- Nausea
- Abdominal pain
- Loose stools
Menos comuns efeito secundários
- Vomiting
- Headache
- Dizziness
- Flatulence
- Dyspepsia (indigestion)
Efeitos secundários graves (rare)
- 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 tratamentos
| Treatment | Route | Notes |
|---|---|---|
| Ceftriaxone | IM injeção | Preferred first-line per EU/WHO guidelines; high efficacy |
| Cefixime | Oral comprimido | Second-line oral option; resistance increasing |
| Azithromycin (Zithromax) | Oral comprimido | Formerly combined with cefixime; limited monotherapy role now |
| Spectinomycin | IM injeção | 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 tratamento 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 médico with awareness of current local resistance patterns.
Como aceder a Cefixime online na Europa
Cefixime is a medicamento sujeito a receita médica (POM) in all estados-membros da UE. It cannot legally be dispensed without a valid receita médica from a licensed medical professional.
Prescrivia operates as a technology intermediary: we do not prescribe medicamentos, employ médicos, or sell medicamentos. Our platform connects pacientes with independent EU-registered médicos who can conduct confidential online health assessments.
The process:
- Complete uma avaliação de saúde: Provide details of your symptoms, sexual history, any prior STI testing, and medications or allergies.
- Avaliação médica: An independent EU-registered médico reviews your assessment. If cefixime is clinically appropriate based on your circumstances, they may issue a receita médica.
- Dispensa na farmácia: The receita médica is sent to a licensed EU farmácia partner for dispensing and direct delivery.
Important: A Prescrivia não garante that a receita médica will be issued. For gonorrhoea, testing and culture are strongly recommended. All prescribing decisions are made independently by qualified medical professionals.
Informação de segurança importante
Informe o seu médico before taking Cefixime if you:
- 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 medicamentos, including anticoagulants (cefixime may interact with warfarin)
Test of cure: After tratamento for gonorrhoea, a test of cure (repeat testing 1–2 weeks after tratamento) is strongly recommended to confirm successful eradication of the infection, as per European STI guidelines.
Partner notification: If diagnosed with gonorrhoea or another STI, sexual partners should be informed and offered testing and tratamento. This is an important step in preventing reinfection and reducing transmission.
Fontes
Medical information on this page is based on the following sources:
- Organização Mundial da Saúde (WHO). WHO Guidelines for the Treatment of Neisseria gonorrhoeae. 2016. who.int
- European STI Guidelines Editorial Board. 2021 European guideline on the diagnosis and tratamento of gonorrhoea in adults. Journal of the European Academy of Dermatology and Venereology.
- Organização Mundial da Saúde (WHO). WHO Model List of Essential Medicines. 22nd edition, 2021.
- Agência Europeia de Medicamentos (EMA). Cefixime — Summary of Product Characteristics. Available at: ema.europa.eu
This content is reviewed periodically to reflect updated clinical guidance. It is provided for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for advice relevant to your individual health circumstances.
Frequently asked questions
- O que é Cefixime utilizado para in sexual health?
- Cefixime is a third-generation cephalosporin antibiotic primarily used in sexual health for the tratamento of uncomplicated gonorrhoea (Neisseria gonorrhoeae infection). European and WHO guidelines have historically included cefixime as a component of gonorrhoea tratamento 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 tratamento 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 médico will advise on the most appropriate tratamento.
- Como é 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 médico'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 médico before starting tratamento.
- Posso obter Cefixime online na Europa?
- Cefixime is a medicamento sujeito a receita médica in all estados-membros da UE. You can access it through online intermediary platforms that connect you with independent EU-registered médicos who can conduct a confidential health assessment and, if appropriate, issue a receita médica.
Tratamentos
A Prescrivia é apenas uma plataforma intermediária. Não prestamos serviços médicos, não prescrevemos tratamentos nem dispensamos medicamentos. Todas as decisões médicas são tomadas por médicos independentes registados na UE. Todos os medicamentos são dispensados por farmácias licenciadas na UE. Esta plataforma facilita a ligação entre pacientes e prestadores de cuidados de saúde.