Pharmacokinetics of cefixime in the young and elderly

Abstract

The pharmacokinetics of cefixime were compared in 12 young and 12 elderly subjects receiving 400 mg once-a-day for five days. Mean peak serum concentrations (Cmax) on days one and five in the elderly (4.90 and 5.68 mg/l) were comparable (P greater than 0.05) to those in the young subjects (3.88 and 4.74 mg/l). Serum area under the curve (AUC) values on days one and five in the elderly (41.0 and 49.5 mg.h/l) were higher (P less than 0.05) than those in young subjects (28.6 and 34.9 mg.h/l). In addition, the elimination half-life, mean residence time, average concentration, minimal concentration and renal clearance (Clr) values were significantly higher (P less than 0.05) in the elderly. A significant linear correlation (P less than 0.05) was found between the Clr of cefixime (total and unbound) and creatinine clearance. The urinary recovery (Ae0----24) and protein binding of cefixime on days one and five was similar in the elderly and young. Overall, there is no need for any dosage adjustment of the drug in the elderly.

Cefixime

“…Slightly higher serum AVC, elimination half-life, and serum concentration values as well as lower renal clearance values were found in the elderly subjects, but these differences were thought to be clinically insignificant. 5 Cefixime pharmacokinetics in pediatric subjects after a 6 mg/kg oral dose were found to be similar to those previously reported for adult subjects after a 4OO-mg oral dose." Although it appears from the data available that cefixime kinetics are not greatly altered by extremes of age, further studies are needed to define more clearly the drug's pharmacokinetics in these patient populations.…”

Antimicrobial Therapy for the Elderly Patient

“…Cefixime is the only currently available oral third‐generation cephalosporin; it has a spectrum similar to that of cefotaxime and ceftriaxone. In studies of cefixime in elderly subjects, diminished renal clearance with higher serum half‐life was found 118 . The dose is 400 mg once or twice a day.…”

Prospective Randomized Controlled Study of the Results of Medication with Oral Ciprofloxacin versus Oralcefixime to Prevent Transient Bacteraemia and Adverse Events from Trans-Rectal Prostatic Biopsy

“…In the present study, we evaluated whether oral cefixime could be used as an effective alternative antibiotic prophylaxis for men undergoing trans-rectal prostatic biopsy. Cefixime is a third-generation cephalosporin and is commonly used to treat bacterial infections of the ear, urinary tract, and upper respiratory tract (20). It can also be administered easily in an oral form, and our local resistance data in 2015 showed that ≈65% of coliforms that were isolated from urine samples were resistant to ciprofloxacin, whereas only 25% of coliforms were resistant to cefixime (14).…”