Cefixime

PD Dialyzability: Likely

Pharmacokinetic Parameters [1] [2]

  Cefixime
Molecular Weight (Da) 453.45
Plasma Protein Binding (%) 65
Volume of Distribution (L/Kg) 0.6–1.1
Hepatic Metabolism N/A
Excreted Unchanged (%) 18-50
Half-Life; Normal Renal Function (hours) 3.0-4.0
Half-Life; ESRD (hours) 11.5

CAPD Dosing: [3] [4] [5]

  • 200mg PO daily

CCPD Dosing:

  • One study identified. See literature summary below. [6]

Indication Specific PD Dosing:

  • Peritonitis treatment - 400mg PO daily [7]
  • Urinary Tract Infection - 400mg PO every 2 days (see literature summary below) [8]

Literature Summary:

Title Patient Intervention Outcome Note
Pharmacokinetics of cefixime (CL 284,635; FK 027) in healthy subjects and patients with renal insufficiency.
[8]
  • CAPD
  • 4 patients on CAPD diagnosed with urinary tract infection.
 Cefixime 400mg PO Every 2 Days.
  • Cefixime concentration 24 hours post initial dose.
  • MIC’s for urinary pathogen.
  • No ADR reported
  • Study suggests extension of dosing interval may be considered over dose reduction.
Peritonitis due to Moraxella phenylpyruvica.
[6]
  • CCPD
  • 70 year old woman
  • Presenting with abdominal pain, vomiting, and fever.
  • Diagnosed with peritonitis due to Morexalla phenypyruvica.
 Cefixime 400mg PO daily x 7 days.
  • Complete resolution of fever and symptoms of peritonitis.
  • Hemodialysis (HD) initiated.
  • No ADR reported

References

[1]Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. DrugBank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(suppl_1):D668–72.
[2]American Pharmacist Association. Drug information handbook: a comprehensive resource for all clinicians and healthcare professionals [Internet]. Hudson, Ohio: American Pharmacist association; 2012 [cited 2018 Jan 24]. Available from: http://online.lexi.com.login.ezproxy.library.ualberta.ca/lco/action/home?siteid=1
[3]Aronoff GR. Drug prescribing in renal failure: dosing guidelines for adults and children. 5th ed. Philadelphia, PA: American College of Physicians; 2007.
[4]Adjusting oral antibiotics to estimated creatinine clearance [Internet]. [cited 2018 Jan 24]. Available from: http://www.vhpharmsci.com/VHFormulary/Tools/ADJUSTING%20ORAL%20ANTIBIOTICS.pdf
[5]Gilbert B, Robbins P, Livornese LL. Use of Antibacterial Agents in Renal Failure. Med Clin North Am. 2011;95:677–702.
[6](1, 2) Cirillo P, Melfitano A, Pepe V, delli Carri P, Gesualdo L. Peritonitis due to Moraxella phenylpyruvica. Perit Dial Int. 2009;29:358–359.
[7]Williams JD, Coles GA. CAPD Peritonitis. Int J Antimicrob Agents. 1992;1:165–174.
[8](1, 2) Guay DR, Meatherall RC, Harding GK, Brown GR. Pharmacokinetics of Cefixime ( CL 284 , 635 ; FK 027 ) in Healthy Subjects and Patients with Renal Insufficiency. Antimicrob Agents Chemother. 1986;30(3):485–90.