Čo je 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.
Ako funguje Cefixime?
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
Pre koho je určený/á Cefixime?
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)
Dávkovanie
| 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 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.
Vedľajšie účinky
Časté vedľajšie účinky (postihujúce 1 až 10 zo 100 osôb)
- Diarrhoea
- Nausea
- Abdominal pain
- Loose stools
Less common side effects
- Vomiting
- Headache
- Dizziness
- Flatulence
- Dyspepsia (indigestion)
Serious side effects (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 treatments
| Treatment | Route | Notes |
|---|---|---|
| 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.
Ako získať Cefixime online v Európe
Cefixime je liek viazaný na lekársky predpis vo všetkých členských štátoch EÚ. Nemožno ho legálne vydať bez platného predpisu od licencovaného lekára.
Prescrivia pôsobí ako technologický sprostredkovateľ: nepredpisujeme lieky, nezamestnávame lekárov ani nepredávame lieky. Naša platforma spája pacientov s nezávislými lekármi registrovanými v EÚ, ktorí môžu vykonávať dôverné online zdravotné posúdenia.
Postup je nasledovný:
- Vyplňte zdravotný dotazník: Provide details of your symptoms, sexual history, any prior STI testing, and medications or allergies.
- Posúdenie lekárom: An independent EU-registered doctor reviews your assessment. If cefixime is clinically appropriate based on your circumstances, they may issue a prescription.
- Predpis a vybavenie: The prescription is sent to a licensed EU pharmacy partner for dispensing and direct delivery.
Important: 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.
Dôležité bezpečnostné informácie
Tell your doctor 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 medicines, including anticoagulants (cefixime may interact with warfarin)
Test of cure: 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.
Partner notification: 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.
Zdroje
Lekárske informácie na tejto stránke vychádzajú z nasledujúcich zdrojov:
- 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. Available at: ema.europa.eu
Tento obsah je pravidelne prehodnocovaný s ohľadom na aktualizované klinické usmernenia. Je poskytovaný len na informačné účely a nepredstavuje lekárske poradenstvo. Vždy sa poraďte s kvalifikovaným zdravotníckym pracovníkom o rade týkajúcej sa Vašich individuálnych zdravotných okolností.
Frequently asked questions
- Na čo sa používa Cefixime?
- 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.
- Aký je rozdiel 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.
- Môžem získať Cefixime online v Európe?
- Prístup k prípravku môžete získať prostredníctvom online sprostredkovateľských platforiem, ktoré Vás spoja s nezávislými lekármi registrovanými v EÚ. Po vyplnení dôverného zdravotného dotazníka lekár posúdi, či je liek pre Vás klinicky vhodný.
Liečba
Prescrivia je iba sprostredkovateľská platforma. Neposkytujeme lekárske služby, nepredpisujeme liečbu ani nevydávame lieky. Všetky lekárske rozhodnutia robia nezávislí lekári registrovaní v EÚ. Všetky lieky vydávajú licencované lekárne v EÚ. Táto platforma uľahčuje spojenie medzi pacientmi a poskytovateľmi zdravotnej starostlivosti.