Clinical pharmacokinetics of cefixime: a systematic review

Abstract

1. Cefixime is an antibiotic from the cephalosporin class used to treat various bacterial infections. The purpose of performing this review is to thoroughly evaluate the pharmacokinetic (PK) data on cefixime

2. Five databases were systematically searched to identify studies on the PK of cefixime.

3. A total of 38 articles meeting the eligibility criteria were included that provide data on concentration-time profiles or PK parameters such as peak plasma and serum concentration (C_max), area under the curve (AUC), clearance (CL), and time to reach C_max (t_max). A dose-dependent increase in AUC and C_max of cefixime was depicted in healthy volunteers. The clearance of cefixime decreased according to the degree of renal insufficiency among haemodialysis patients. A significant difference in CL was found in comparing fasted and fed states. A biphasic decline in serum concentrations of cefixime was reported when it was taken without probenecid.

4. This review compiles all the reports on the PK of cefixime in healthy and really impaired patients; the summarised information can be used to optimise cefixime dosing in different disease states. Moreover, cefixime has increased time above MIC value suggesting that it may be an effective treatment for infections caused by certain pathogens.

Keywords:

• Cefixime
• pharmacokinetic
• urinary tract infection
• systematic review
• clearance

Author contributions

All authors have made substantial contributions to the design, extraction, analysis, and interpretation of data and have actively participated in drafting and revising the article. All authors agreed to submit the final version to the journal and agreed to be accountable for all aspects of the work.

Disclosures statement

The authors declare that they have no potential conflicts of interest that might be relevant to the contents of this manuscript.

Data availability statement

All the data used for this publication is either presented in the main article or is available as supplementary information.

Additional information

Funding

This work was supported by Distinguished Scientist Fellowship program at King Saud University, Riyadh, Saudi Arabia [RSP2023R131].