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PubMedDate not supplied

Disposition of cefixime in the pregnant and lactating rat. Transfer to the fetus and nursing pup.

The disposition of cefixime, a potent, third generation, orally active cephalosporin, was characterized in the pregnant and lactating rat. After a single iv dose of 17.8 mg/kg 14C-cefixime to day 18 pregnant rats, the half-life for elimination of radioactivity from both maternal serum and placentas was 6.9 hr. Elimination from fetal plasma and tissues was somewhat longer, 12.5 and 13.7 hr, respectively. However, comparison of areas under the curve indicated that exposure of the fetuses to cefixime was far less than that of placentas. Whole body autoradiography showed the greatest radioactivity in maternal liver, kidney, and intestines. In the lactating rat, steady state plasma concentrations of 14C-cefixime were achieved by continuous ip infusion of 2.54 mg/kg/day via Alza osmotic Mini-pumps from days 10 to 14 postpartum. Plasma concentrations of radioactivity in the dams were, on the average, 70 times greater than in their nursing pups throughout the study. After 102 hr of drug infusion, total radioactivity in the body of the pups, including the stomach and intestinal contents, was 1% of the 14C-cefixime estimated to be in the mother's body at steady state. Overall, these data indicate that exposure of the developing rat fetus and nursing pup to cefixime after maternal drug administration is quantitatively small.

Animals↗
PubMed1986

Comparison of cefixime and co-trimoxazole in acute uncomplicated urinary tract infection. A double-blind general practice study.

Five hundred and twenty-eight patients with presumptive acute uncomplicated urinary tract infection (UTI) were randomly assigned to receive cefixime 400 mg once daily, cefixime 200 mg twice daily or co-trimoxazole 2 tablets twice a day for 10 days; 477 completed at least 5 days of therapy. Of the patients 342 (65%) had positive baseline urine cultures, yielding 353 pathogens. A microbiological response was determined for 280 pathogens (79%), eradication being observed in over 94% of isolates; 153 pathogens (43%) were sensitive to both cefixime and co-trimoxazole and eradication was observed in over 96% of cases. Clinical response correlated well with microbiological response. The incidence of diarrhoea and stool changes was higher (P less than 0.005) in the patients who received cefixime once daily than in the other groups. There was a significantly higher incidence of stool changes with cefixime twice daily than with co-trimoxazole (P less than 0.05), but these did not necessitate discontinuation of therapy. Nausea was commoner with co-trimoxazole (P less than 0.05). The majority of pathogens isolated were Escherichia coli, Proteus mirabilis and staphylococci. Approximately 24% of E. coli were resistant in vitro to co-trimoxazole (P less than 0.005). Cefixime 200 mg twice daily is an effective and safe alternative to co-trimoxazole in the management of acute uncomplicated UTI.

Adult↗
PubMed1987

Liquid-chromatographic determination of five orally active cephalosporins--cefixime, cefaclor, cefadroxil, cephalexin, and cephradine--in human serum.

We report an isocratic "high-performance" liquid-chromatographic (HPLC) procedure for measurement of five orally administered cephalosporins (cefixime, cefaclor, cefadroxil, cephalexin, and cephradine) in 0.1 mL of human serum. Serum protein is precipitated with acetonitrile, the sample is centrifuged, and the supernate is evaporated under nitrogen. The residue is reconstituted in 0.1 mL of mobile phase, and 50 to 80 microL of this is injected onto a reversed-phase Altex Ultrasphere Octyl (C8) column. The five cephalosporins are resolved by elution with a pH 2.6 mobile phase of methanol/monobasic phosphate buffer (20/80) by vol), flow rate 2 mL/min. The column effluent is monitored at 240 nm. Cefixime serves as the internal standard for the analysis of the four other compounds, cephalexin as the internal standard for cefixime. We used two standard curves for all compounds: a low-range curve for concentrations commonly observed clinically and a higher-range curve for higher concentrations. The former were linear from 1.0 to 10 mg/L for cefaclor, cefadroxil, cephalexin, and cephradine and from 0.1 to 1 mg/L for cefixime. The high-concentration curves were linear from 1 to 10 mg/L for cefixime and from 10 to 100 mg/L for the other compounds. The detection limits were 0.1 mg/L for cefixime, 1 mg/L for the other cephalosporins. Mean within-run and day-to-day CVs were always less than 15% for all compounds studied.

Cefaclor↗
PubMed1997

Cefixime: an oral option for the treatment of multidrug-resistant enteric fever in children.

BACKGROUND: Enteric fever is a serious public health problem in Pakistan, where multidrug-resistant salmonellosis causes enteric fever with increased morbidity and mortality. Costly parenteral therapy and lack of an established safety profile for the use of quinolones in children necessitate evaluation of an oral treatment option. This study is meant to assess the efficacy, safety, and cost effectiveness of an oral third-generation cephalosporin (cefixime) in the treatment of multidrug-resistant enteric fever. METHODS: Between November 1993 and October 1994, 85 patients, 15 years of age or less, with culture-proven enteric fever were randomly assigned to two groups. Group A (n = 41) received cefixime at a dosage of 10 mg/kg to 12 mg/kg per day in two divided doses. Group B (n = 44) received chloramphenicol at a dosage of 100 mg/kg daily in four divided doses. Both groups were treated for 2 weeks. RESULTS: In group A, 95% (39/41) of the patients receiving cefixime responded favorably, whereas in group B, 30% (14/45) responded to chloramphenicol. The 31 patients not cured in group B were then successfully treated with cefixime. Overall, cefixime was well tolerated. Subsequent antibiogram data showed an overall multidrug-resistance rate of 78% (66/85). CONCLUSIONS: Cefixime is a safe, effective, and cheaper oral option for the treatment of multidrug-resistant enteric fever. Further studies are needed, however, to validate this observation.

Administration, Oral↗
PubMed1998

[Cefixime versus amoxicillin plus netilmicin in the treatment of community-acquired non-complicated acute pyelonephritis].

BACKGROUND: Community-acquired non-complicated acute pyelonephritis (APN) is a frequent, occasionally serious infection (around 20% of the cases are bacteremic) that usually requires hospital admission. The third generation oral cephalosporins which are active against more than 95% of E. coli strains should allow the outpatient management of these patients. OBJECTIVE: To evaluate the bacteriological and clinical efficacy of oral cefixime in comparison to amoxicilin plus netilcilin in the treatment of APN. PATIENTS AND METHODS: Patients older than 18 years affected by APN were included in a fourteen month prospective study. According to a random numbers chart, the patients received cefixime (400 mg/24 h in a single daily dose for 12 days) or amoxicilin (1 g/8 h per os) plus netilmicin (4 mg/kg/24 h in a single intramuscular daily dose) during five days followed by 7 days of an oral treatment chosen according to the susceptibility pattern of isolated microorganism. RESULTS: Sixty-one patients received cefixime and 65 amoxicillin plus retilmicin. There were no significant differences between both groups of patients. Thirty-two patients presented bacteremia (25.4%). The mean (SD) eak and trough concentrations of netilmicin were 11.4 (2.8) mg/l and 0.38 (0.4) mg/l, respectively. Clinical response was favorable in 97% of patients treated with cefixime and in 98% of those treated with amoxicilin plus netilmicin (p = NS). The infection recurred in 10 out of 59 patients (16.9%) in the cefixime arm of the study and in 9 out of 64 patients (14%) treated with amoxicillin plus netilmicin (p = NS). Tolerance to the study drugs was good in both arms of the study, and renal function remained normal. CONCLUSION: Cefixime seems to be an acceptable alternative to the regimens containing an aminopenicillin and an aminoglycoside for the treatment of community-acquired non-complicated APN.

Acute Disease↗
PubMed1999

Antibacterial activity of cefixime against Salmonella typhi and applicability of Etest.

Recent clinical studies have shown the excellent efficacy of cefixime for the treatment of typhoid fever. In this study, the in vitro antibacterial activity of various antibiotics including cefixime against 73 clinical isolates of Salmonella typhi from a variety of sources was evaluated by the conventional agar-dilution method and Etest. Eighteen strains of these 73 isolates were chloramphenicol- and cotrimoxazole- (sulfamethoxazole-trimethoprim) resistant, and 12 of these 18 strains were also resistant to amoxicillin because of beta-lactamase production. Cefixime showed excellent activity against all 73 strains with an MIC90 value of 0.25 &mgr;g/ml. Reflecting its high beta-lactamase stability, cefixime also had excellent activity against beta-lactamase-producing amoxicillin-resistant strains. Antibacterial activity of cefixime was comparable to ceftriaxone, ofloxacin, and ciprofloxacin, which are often used for the treatment of typhoid fever. The MIC values obtained from the Etest correlated well with the results of the conventional agar-dilution method, suggesting the usefulness of the Etest as a new easy MIC determination method. The microbiological results supplement the previous clinical data, which showed that oral cefixime provides a safe and effective alternative for the treatment of typhoid fever, even in cases of multidrug-resistant S. typhi.

Journal Article↗
PubMed1988

Absolute bioavailability of cefixime in man.

In a four-way cross-over study, the absolute bioavailability of cefixime was determined in 16 healthy volunteers. Each subject received a single 200-mg dose as an intravenous (IV) and oral solution, and 200-mg and 400-mg capsule doses of the drug. Blood and urine samples were collected for 24 hours after each dose. Cefixime was well tolerated after IV and oral doses of the drug and no serious drug-related adverse effects were observed. The maximal serum concentration (Cmax) of cefixime following the 200-mg oral solution and 200-mg and 400-mg capsule doses were 3.22, 2.92, and 4.84 micrograms/mL, respectively. Mean area under the serum concentration time curves (AUC) following the IV, 200-mg oral solution, and 200-mg and 400-mg capsule doses were 47.0, 26.0, 23.6, and 39.4 micrograms.hr/mL, respectively. Mean elimination half-life values of the drug were comparable after oral and IV doses, ranging from 3.2 to 3.5 hours. Based on serum AUC values, the absolute bioavailability of cefixime was 52.3%, 47.9%, and 40.2% after the 200-mg oral solution, 200-mg capsule and 400-mg capsule doses, respectively. Respective ratios based on 24-hour urinary recovery data were 44.7%, 41.7%, and 40.5%. Therefore, the results show that the percent of cefixime adsorbed after 200-mg and 400-mg oral doses was similar.

Administration, Oral↗
PubMed1990

[Treatment results using cefixime for bacterial respiratory tract infections].

In a prospective open clinical trial 20 patients with the diagnosis bacterial respiratory tract infection and underlying chronic obstructive lung disease were treated for 13 to 17 days with 200 mg cefixime b. i. d. 14 of 16 evaluable patients were treated successfully. In one patient the clinical symptoms remained unchanged and in another patient cefixime treatment failed. Ten of the 16 evaluable patients showed a positive baseline culture. In nine of these patients the initially isolated pathogens could be eliminated. In one patient, in whom cefixime therapy failed, change of pathogens was noticed after the end of treatment. Four of the 20 patients treated with cefixime reported side effects (gastritis, three; fungal dermatitis, one). In the patient with fungal dermatitis cefixime therapy was stopped.

Adult↗
PubMed1989

Comparative activity of cefixime and cefaclor in an in vitro model simulating human pharmacokinetics.

The dependence of the antibacterial activity of the two oral cephalosporins cefixime and cefaclor on pharmacokinetic properties was investigated in an in vitro model using strains of enterobacteria and a streptococcal strain. In the cultures the course of serum concentrations of the respective antibiotic was simulated. The more rapidly attained (1 h) high peak levels (17.5 micrograms/ml) of cefaclor (500 mg dose) in no case showed an advantage over the more slowly reached (3 h) low peak levels (2.5 micrograms/ml) of cefixime (200 mg dose). Cefixime was comparable to cefaclor with respect to its initial killing velocity, whereas it was generally superior with respect to maximum values for reduction of bacterial counts. Due to its long elimination half-life (2.5 h) cefixime prevented regrowth for at least twice as long as cefaclor, which has a short half-life (0.7 h). As a result of its antibacterial activity and pharmacokinetic properties cefixime can be administered less frequently than cefaclor.

Cefaclor↗
PubMed1988

Comparative, multicenter studies of cefixime and amoxicillin in the treatment of respiratory tract infections.

A total of 560 patients were treated in two double-blind, randomized multicenter studies to compare the safety and efficacy of cefixime (400 mg administered once daily) and amoxicillin (250 or 500 mg administered three times daily) for the treatment of bacterial respiratory tract infections. Eighty percent of the 244 patients treated in the lower respiratory tract infections (LRTI) study had acute bronchitis. Streptococcus pneumoniae (13 percent), Haemophilus influenzae (28 percent), and Escherichia coli (10 percent) were the pathogens most frequently isolated from sputum in these patients. Among evaluable patients with positive bacterial culture results at baseline, a favorable clinical response (cured or improved) was obtained in 100 percent of the cefixime-treated patients (22 of 22) and in 96 percent of the amoxicillin-treated patients (23 of 24). Bacteriologic eradication rates were 100 percent and 83 percent for cefixime and amoxicillin, respectively. In the upper respiratory tract infections (URTI) study, 316 patients with pharyngitis (80 percent) or tonsillitis (14 percent) were treated. Group A, beta-hemolytic Streptococcus (69 percent) and H. influenzae (8 percent) were the pathogens most frequently isolated from the throat culture specimens of these patients. Favorable clinical results were obtained in 99 percent of the evaluable cefixime-treated group (n = 73) and in 98 percent of the amoxicillin-treated group (n = 66). The bacteriologic eradication rates were 93 percent and 100 percent, respectively. The adverse experiences reported during both studies were similar in nature and frequency to those reported for other beta-lactam antibiotics with the exception of a higher incidence of altered bowel movement (diarrhea and stool changes) with both drugs. These episodes usually resolved without remedial medication when the treatment was withdrawn. No significant adverse laboratory findings were observed. Results of these trials demonstrate that cefixime at a dosage of 400 mg once daily is an effective and safe oral antibiotic for the treatment of acute respiratory tract infections.

Amoxicillin↗
PubMed1995

[Comparative study of cefixime versus amoxicillin-clavulanic acid combination in the oral treatment of urinary tract infections in children].

BACKGROUND: Acute febrile infections suggestive of pyelonephritis require treatment by broad-spectrum antibiotics capable of reaching significant tissue levels. This study compares efficacy and safety of cefixime with amoxycillin + clavulanic acid in urinary tract infections. POPULATION AND METHODS: Fifty seven children aged 5 months to 14 years treated for urinary tract infection in ten pediatric centres for a period of 10 months had been randomly included in the study. Thirty (22 girls and eight boys) were given cefixime and 27 (24 girls and three boys) amoxycillin-clavulanate. Efficacy was evaluated in only 36 patients whose bacteria were susceptible to both antibiotics (26 pyelonephritis and ten cystitis). RESULTS: Sixteen patients out of the 19 given cefixime recovered vs. 14 out of the 17 given amoxycillin-clavulanate with no significant difference between both groups. Bacteria were more often susceptible to cefixime (100% of cases) than to amoxycillin-clavulanate (69%) (p < or = 0.0001). Safety was good and comparable in both groups. CONCLUSION: Cefixime given per os seems effective and safe in treating urinary tract infections. These results have to be confirmed by further studies.

Administration, Oral↗
PubMed2005

Pharmacokinetic-pharmacodynamic modelling of antibacterial activity of cefpodoxime and cefixime in in vitro kinetic models.

The bacterial time-kill curves of cefpodoxime and cefixime against four bacterial strains (Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae/penicillin sensitive and S. pneumoniae/penicillin intermediate) were compared in in vitro infection models in which various human pharmacokinetic profiles of unbound antibiotic were simulated. This approach offers more detailed information than the minimum inhibitory concentration (MIC) does about the time course of antibacterial efficacy of an antibiotic. A pharmacokinetic-pharmacodynamic (PK-PD) model based on unbound antibiotic concentrations at the site of infection, and a sigmoid Emax-relationship with EC50 as the antibiotic concentration necessary to produce 50% of the maximum effect, effectively described the antimicrobial efficacy of both cefpodoxime and cefixime. The EC50 values of cefpodoxime and cefixime were consistent with their respective MIC values. Both antibiotics had similar high potency against H. influenzae (EC50: 0.04 mg/L) and M. catarrhalis (EC50: 0.12 mg/L), while the potency of cefpodoxime against S. pneumoniae strains was about 10-fold higher than that of cefixime (EC50s/sensitive strain: 0.02 mg/L versus 0.27 mg/L; EC50s/intermediate strain: 0.09 mg/L versus 0.69 mg/L). Applications of this model and unbound tissue PK profiles obtained from a previous clinical study performed in our group, showed that cefpodoxime has higher bacteriological potency than cefixime against S. pneumoniae. Simulations based on this model allow the comparison of antibacterial efficacy of different antibiotics and dosing regimens.

Anti-Bacterial Agents↗
PubMedDate not supplied

Cefixime in the treatment of patients with lower respiratory tract infections: results of US clinical trials.

Community-acquired acute lower respiratory tract infections are a common cause of illness, accounting for millions of physician visits and prescriptions each year. Cefixime is an extended-spectrum oral cephalosporin with activity against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, the most commonly isolated bacterial pathogens. This review presents the results of eight US studies comparing the efficacy and safety of cefixime with those of amoxicillin, amoxicillin/clavulanate, cefaclor, cephalexin, and cefuroxime axetil in the treatment of patients with acute lower respiratory tract infections. Data for 211 cefixime-treated patients and a range of 19 to 49 patients in the comparator treatment groups were included in the efficacy analysis. Clinical success (cure or improvement) was observed in 94% of cefixime-treated patients; clinical success rates in the comparator treatment groups ranged from 97% for cefuroxime axetil and cefaclor to 79% for amoxicillin/clavulanate. At the end of treatment, the overall eradication rate in the cefixime treatment group was 92% and ranged from 76% (cefaclor) to 98% (cefuroxime axetil) in the comparator treatment groups. The percentage of persistent organisms was highest in the cefaclor (24%) and cephalexin (21%) treatment groups. With the exception of the cephalexin group (4%), the incidence of patients who reported adverse experiences was similar across treatment groups (34% to 50%). Those involving the gastrointestinal tract were by far the most common, and most adverse experiences were rated as mild or moderate in severity.

Adult↗
PubMed1999

A clinical trial comparing oral azithromycin, cefixime and no antibiotics in the treatment of acute uncomplicated Salmonella enteritis in children.

OBJECTIVE: The objective of this study was to perform a prospective, randomized, controlled study to evaluate the role of azithromycin and cefixime in the treatment of uncomplicated non-typhoid Salmonella enteritis in children. METHODOLOGY: Patients with Salmonella enteritis were randomized to receive oral azithromycin (10 mg/kg/day once daily), cefixime (10 mg/kg/day divided twice daily) or no antibiotics for 5 days. The patients were followed up for the duration of their symptoms. Stool samples were sent for culture weekly following the therapy until two consecutive negative results were obtained. Susceptibility of the isolates to antibiotics was tested by the disk diffusion method. RESULTS: Forty-two patients with acute, uncomplicated, culture-confirmed Salmonella enteritis were studied. Duration of diarrhoea and time to defervescence after the therapy were not significantly different for patients treated with azithromycin, cefixime, or no antibiotics; there also were no significant differences with respect to the rate of clearance of Salmonella from stools among the three groups. Salmonella typhimurium was the most common serotype isolated. All 42 isolates were sensitive to cefixime, while two strains (5%) were resistant to azithromycin. CONCLUSION: Azithromycin or cefixime provides no benefit to paediatric patient with uncomplicated Salmonella enteritis.

Administration, Oral↗
PubMedDate not supplied

[Prophylaxis of recurrent urinary tract infections in children. Results of an open, controlled and randomized study about the efficacy and tolerance of cefixime compared to nitrofurantoin].

UNLABELLED: Urinary tract infections are quite frequent in children. Urinary tract obstruction combined with recurrent urinary tract infections increase the risk for renal impairment. Therefore prophylaxis of reinfection is an important nephroprotective procedure. The aim of this open, controlled, randomised pilot study was to compare the efficacy and tolerance of a low dose prophylaxis with Cefixime versus Nitrofurantoin. 60 girls aged 1 to 11 years with at least 2 urinary tract infections within the preceding year were included in the study. The minimum duration of therapy was 6 months and was extended to 12 months for most of the children. The number of recurrent infections was the main criteria for efficacy evaluation, whereas adverse events were analysed to evaluate tolerance. Statistical significant differences between the two treatment groups, regarding recurrence rates could not be demonstrated. Tolerance was comparable in both groups. The influence on gut flora of cefixime given as a low dose regimen over a long period of time corresponds with already published results and was not correlated with a higher number of gastrointestinal side effects. CONCLUSION: Low-dose Cefixime (2 mg/kg bodyweight) is effective and well tolerated in the prophylaxis of recurrent urinary tract infections. Efficacy and tolerance of cefixime were comparable to the results obtained with nitrofurantoin. Due to the small number of patients this study was only a pilot study. Low-dose cefixime, however, could become an alternative to standard regimens in the prophylaxis of recurrent urinary tract infections. This should be investigated in further studies.

Age Factors↗
PubMed1991

A comparison of single-dose cefixime with ceftriaxone as treatment for uncomplicated gonorrhea. The Gonorrhea Treatment Study Group.

BACKGROUND: Because of the widespread existence of Neisseria gonorrhoeae resistant to penicillin or tetracycline, ceftriaxone is now recommended for the treatment of gonorrhea. There is, however, a need for effective antibiotics that can be administered orally as an alternative to ceftriaxone, which requires intramuscular administration. Cefixime is an orally absorbed cephalosporin that is active against resistant gonococci and has pharmacokinetic activity suitable for single-dose administration. METHODS AND RESULTS: In a randomized, unblinded multicenter study of 209 men and 124 women with uncomplicated gonorrhea, we compared three single-dose treatment regimens: 400 mg or 800 mg of cefixime, administered orally, and 250 mg of ceftriaxone administered intramuscularly. The overall cure rates were 96 percent for the 400-mg dose of cefixime (89 of 93 patients) (95 percent confidence interval, 93.5 percent to 97.8 percent); 98 percent for the 800-mg dose of cefixime (86 of 88 patients) (95 percent confidence interval, 94.6 percent to 100 percent); and 98 percent for ceftriaxone (92 of 94 patients) (95 percent confidence interval, 94.9 to 100 percent). The cure rates were similar in men and women, and pharyngeal infection was eradicated in 20 of 22 patients (91 percent). Thirty-nine percent of 303 pretreatment gonococcal isolates had one or more types of antimicrobial resistance; the efficacy of all three regimens was independent of the resistance pattern. Chlamydia trachomatis infection persisted in at least half the patients infected in each treatment group. All three regimens were well tolerated. CONCLUSIONS: In the treatment of uncomplicated gonorrhea, a single dose of cefixime (400 or 800 mg) given orally appears to be as effective as the currently recommended regimen of ceftriaxone (250 mg given intramuscularly).

Administration, Oral↗
PubMed1995

Evaluation of short-course therapy with cefixime or rifampin for eradication of pharyngeally carried group A streptococci. The Ontario GAS Study Group.

Therapy to eradicate pharyngeally carried group A streptococci (GAS) has increasingly been used in the management of institutional outbreaks and is now recommended for household contacts of patients with streptococcal toxic shock syndrome. In this randomized, controlled trial, contacts of patients with GAS infections were screened for pharyngeal GAS colonization. Those whose cultures were positive were randomized to receive either cefixime (8 mg/[kg.d]; maximum 400 mg) or rifampin (20 mg/kg; maximum, 600 mg) once a day for 4 days. Two to five days following completion of therapy, repeated cultures were negative for 13 (38%) of 34 rifampin recipients and 71 (77%; 95% CI, 69%-85%) of 97 cefixime recipients. At 10-14 days after treatment, only 53% of cefixime recipients remained culture-negative. Rates of successful clearance improved with increasing age (P < .01); among 17 adults who received cefixime, the success rate was 94%. Four days of therapy with rifampin is not effective for eradication of pharyngeally carried GAS. Four days of therapy with cefixime may be effective for adults, but further studies are needed.

Adolescent↗
PubMed1995

Short course chemotherapy with cefixime in children with multidrug-resistant Salmonella typhi Septicaemia.

Increasing prevalence of multidrug-resistant (MDR) Salmonella typhi strains in pediatric cases of typhoid fever and chemotherapy restrictions in children, such as fluoroquinolones, require ongoing clinical evaluations of different antibiotic regimens. Previously reported clinical trials with oral cefixime therapy given as a 12-day regimen (20-30 mg/kg divided twice daily) demonstrated both safety and efficacy. An open trial was undertaken to investigate a short course (8-day) regimen of oral cefixime in an Egyptian public fever hospital. Eighty children were initially enrolled with blood culture confirmation in 60 children. Clinical cure was documented in 57 (95 per cent) with three children requiring a change in antibiotic regimen due to therapeutic failure and one child with culture-confirmed relapsed 21 days post-therapy. All S. typhi isolates were sensitive to cefixime as measured by disk diffusion. Cefixime was well-tolerated with only mild side-effects, including nausea/vomiting (8 per cent) and abdominal cramping with loose stools (6 per cent), which may have been secondary to typhoid fever. Cefixime given in a short 8-day course is safe and effective in the management of MDR typhoid fever in children.

Adolescent↗