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Cefixime

Cefixime is a high-class medication which is commonly used to treat bacterial infections of the middle ear, urinary tract and upper respiratory tract. The active ingredient Cefixime is a broad-spectrum antibiotic that works by interfering with the ability of bacteria to form cell walls thereby killing them.

Other names for this medication:

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Amoxil, Moxatag, Trimox, Acticlate, Adoxa, Alodox, Avidoxy, Doryx, Monodox, Levaquin, Cipro

 

Also known as:  Cefixime.

Description

Cefixime is created by pharmacy specialists to struggle with dangerous infections spread by bacteria. The target of Cefixime is to control, ward off, terminate and kill bacteria.

Cefixime is known as a third generation cephalosporin antibiotic.

Cefixime works by interfering with the ability of bacteria to form cell walls that are vital for their survival. Cefixime damages the bonds that hold the bacterial cell wall together. This causes the appearing of holes in the cell walls and kills the bacteria.

Cefixime has marked in vitro bactericidal activity against a wide variety of Gram-positive and Gram-negative organisms.

Cefixime and other antibiotics don't treat viral infections (flu, cold and other).

Dosage

Take Cefixime by mouth with a full glass of water with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

The recommended adult dosage is 200-400mg of Cefixime daily according to the severity of infection, given either as a single dose or in two divided doses.

Cefixime is not recommended for use in children less than 6 months of age.

Children older than 6 months and up to 11 years of age should not be given Cefixime as a tablet.

Adolescents 12 years of age and older and children weighing more than 50 kg may be given the same dose of Cefixime as adults.

For elderly patients, the doses of Cefixime are the same as adults provided the kidney functions are normal.

It is better to take Cefixime every day at the same time.

Do not stop taking Cefixime suddenly. The usual course of treatment is 7 days but it may be continued for up to 14 days if required.

Overdose

If an overdose occurs and you are not feeling well, you should seek emergency medical attention or contact your healthcare provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) and away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Cefixime are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not use Cefixime if you are allergic to Cefixime components or other cephalosporin-type antibiotics (e.g., Ceftin, Cefzil, Keflex, Omnicef).

Cefixime is not to use if you are allergic to penicillin-type antibiotics.

Be careful with Cefixime if you take anticoagulants or carbamazepine.

Do not take Cefixime if with BCG vaccine or a live typhoid vaccine because their effectiveness may be decreased by Cefixime.

Do not use Cefixime if you have diarrhea, stomach or bowel problems (eg, inflammation), bleeding or blood clotting problems, liver problems, or poor nutrition.

Do not use Cefixime you have a history of kidney problems or you are on dialysis treatment.

Be careful with Cefixime and inform your doctor that you are taking cefixime if you are having surgery, including dental surgery.

Do not take Cefixime if you're pregnant or a nursing mother.

Do not use Cefixime in children younger than 6 months old.

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One hundred six patients with acute, uncomplicated lower urinary tract infections participated in a randomized study that compared cefixime (one 400-mg tablet once daily) with trimethoprim (160 mg)/sulfamethoxazole (800 mg) (one tablet every 12 hours). Two cefixime recipients and 3 patients given trimethoprim/sulfamethoxazole had courses that were not evaluable for efficacy. At five to nine days post-therapy, 98 percent of the patients in each treatment group had clinical cure and bacteriologic eradication. At four to six weeks post-therapy, 87 percent (34/39) of the cefixime-treated patients and 83 percent (33/40) of those given trimethoprim/sulfamethoxazole had clinical cure and 90 percent (35/39) and 93 percent (37/40) of the patients in the respective treatment groups had bacteriologic eradication. Adverse clinical experiences or changes in the results of laboratory tests were few. Thus, a once-daily dose of cefixime was as safe and as effective as a twice-daily regimen of trimethoprim/sulfamethoxazole.

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Randomized controlled trials of fluoroquinolones in people with blood or bone marrow culture-confirmed enteric fever.

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This study compared the antimicrobial susceptibility and genotypes of strains of Neisseria gonorrhoeae isolated from men who have sex with men (MSM) and from heterosexuals. One hundred and eleven strains were characterized from 107 patients, comprising 57 strains from 54 heterosexuals and 54 strains from 53 MSM. Antimicrobial resistance rates were higher in strains from heterosexual patients, with resistance to cefixime (P = 0·0159) and ciprofloxacin (P = 0·002) being significantly higher. Typing by N. gonorrhoeae multi-antigen sequence typing (NG-MAST) showed that the most prevalent sequence types (ST) and genogroups (G) respectively were ST2400, ST2992, and ST5793, and G1407, G2992, and G2400. A statistically significant association was observed for MSM and genogroups G2400 (P = 0·0005) and G2992 (P = 0·0488), and G1407 with heterosexuals (P = 0·0002). We conclude that in our region distinct populations of gonococci are circulating among subjects with different sexual practices, with their corresponding transmission patterns. Furthermore, the high prevalence of genotype G2400 in MSM, has not to our knowledge been previously described.

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From April 2006 to August 2007, a total of 146 Neisseria gonorrhoeae isolates collected from 139 male patients in Taipei, Taiwan, were analyzed by N. gonorrhoeae multiantigen sequence typing (NG-MAST) and antibiotic susceptibility testing. The resistance rates of all isolates to ciprofloxacin, cefpodoxime, and cefixime were 76.7 (112/146), 21.2 (31/146), and 16.4% (24/146), respectively. NG-MAST identified 71 sequence types (STs), of which 21 STs contained 2 to 21 isolates. The isolates that belonged to the three major ST clusters typically were from patients who had specific epidemiological characteristics (such as sexual orientation and human immunodeficiency virus status). The major ST clones exhibited distinct resistance profiles and are associated with specific groups at high risk of human immunodeficiency virus and syphilis infections.

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Neisseria gonorrhoeae (NG) infection is a serious public health problem. The third-generation extended-spectrum cephalosporins (ESCs) have been used as the first-line treatment for NG infection for almost three decades. However, in recent years, treatment failures with the oral third-generation ESCs have been reported worldwide. This study aimed to estimate worldwide susceptibility rates of NG to cefixime and cefpodoxime by analyzing data from all relevant published studies.

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28 myelomeningocele patients (aged 2-30 years) with clinical symptoms of acute UTI participated in this open uncontrolled clinical trial at the Orthopedic University Hospital of Heidelberg (Dir.: Prof. Dr. H. Cotta). 4 patients were treated with 200 mg cefixime tablets bid, 24 patients received 4 mg/kg body weight cefixime suspension bid, according to age and weight of the patients. The duration of treatment was 6-10 days. Clinical and microbiological examinations were carried out before therapy as well as 1 day and 5 to 9 days after the end of treatment. The data of 25 patients could be evaluated for bacteriological and clinical efficacy. 5-9 days after treatment in 22 patients (88%) complete recovery was stated. In 3 patients a reinfection occurred. In 24 patients (96%) the baseline pathogens were eliminated under cefixime therapy. 5-9 days after the end of treatment in 3 patients reinfection was observed. Clinical side effects could be detected in 1 patient (vomiting). These results indicate that the oral cephalosporin cefixime is efficient and well tolerated in complicated UTI of myelomeningocele patients.

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VLBW-infants below 1500 g of birth weight have a quite high risk to acquire a nosocomial sepsis. 20-40% of all infants exhibit signs of nosocomial infection once during neonatal intensive care. The rate of infection is related to technique and amount of used invasive devices as to gestational age. Coagulase-negative staphylococci (CONS) and gram-negative organisms contribute most to these cases of sepsis. In a three phase study we tried to demonstrate the efficacy of different mechanisms to change the rate of nosocomial sepsis. During the first phase a strict hygienical protocol was enforced as isolation, care with sterile gloves and aseptic techniques in introducing and maintaining i.v. lines. In a second phase we started a randomized controlled study of prophylactic vancomycin (10 mg/kg/day in two doses). In a third phase we added an oral antibiotic regime with cefixime for all patients with positive cultures for gramnegative organisms under the hypothesis of translocation from the gut as the way of infection. During the first phase 23.7% of 76 patients enrolled acquired CONS-sepsis, 0.52% gramnegative sepsis. During the second phase (41 patients) 6 patients in the control group acquired CONS-sepsis, none in the vancomycin-group. The rate of gramnegative infections was not different (4 and 3 cases). During the third phase (vancomycin plus cefixime eventually in cases of positive stool cultures) no case of nosocomial sepsis occurred (35 patients, 11 positive cultures). The management used in phase 3 reduced the rate of nosocomial infections in VLBW-infants drastically.

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This longitudinal, observational study was conducted at Khan Research Laboratories Hospital, Islamabad, Pakistan, from May 2012 to December 2014. All patients presenting with typhoid fever with positive blood culture were included. Age, gender, salmonella serovar and sensitivity to 9 antimicrobial drugs were taken into account. The tested antimicrobial drugs were ampicillin, trimethoprim/sulphamethoxazole, chloramphenicol, nalidixic acid, ciprofloxacin, ofloxacin, levofloxacin, ceftriaxone and cefixime. SPSS 22 was used for analysis.

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Randomised and quasi-randomised controlled trials comparing different antibiotic agents, routes, frequencies or durations of therapy in children aged 0-18 years with proven UTI and acute pyelonephritis were selected.

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Among 254 Neisseria gonorrhoeae isolates from a sexually transmitted infection (STI) clinic in northern Taiwan, 69 isolates were found to contain the mosaic penA (MA) gene and were associated with elevated cefixime and ceftriaxone MICs. Most of these MA gene-harboring isolates were also resistant to penicillin (71.4%) and ciprofloxacin (100%) and were from men who have sex with men (MSM) or from bisexual men (81.2%). Three major sequence types (ST835, ST2180, and ST2253) constituted 55.7% of these isolates. The major sequence types harboring the mosaic penA gene may represent major sexual networks responsible for the emergence/introduction and the spread of the multidrug-resistant clones in Taiwan.

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We studied 33 Klebsiella pneumoniae and 4 Escherichia coli isolates producing ESBLs obtained from outbreaks in 14 different hospitals and a nursing home in the United States. Microdilution testing with standard (10(4-5) colony-forming units/ml) and large (10(6-7) colony-forming units/ml) inocula, was used to compare the minimum inhibitory concentrations (MICs) of ceftibuten, a novel oral oxyimino beta-lactam, with those of other third generation beta-lactams (cefotaxime, ceftazidime, aztreonam, cefixime, cefpodoxime and cefoxitin).

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As part of the Alexander Project during 1992 and 1993, 690 Staphylococcus aureus strains isolated from community-acquired lower respiratory tract infections by clinical microbiology centres located in Europe and the USA were analysed by a co-ordinating laboratory that determined minimal inhibitory concentrations of 15 antimicrobial agents using a standardised microdilution technique. The prevalence of penicillin-susceptible microorganisms in this collection of pathogens was significantly higher in Europe (21.2%) than it was in the USA (12.1%). Most isolates (72.5%), however, were strains that had acquired the ability to synthesise a beta-lactamase but which were sensitive to methicillin. The incidence of methicillin-resistance (9.1% overall) was highly variable depending on geographic location and year of isolation. Analysis of MIC50, MIC90, MIC range and modal MIC of the 15 antibiotics assayed disclosed no major differences between the data sets obtained during the 2-year survey. Except for methicillin-resistant S. aureus, the activity of all the beta-lactams tested, with the exclusion of penicillin, amoxycillin and cefixime (that were completely inactive), was satisfactory. The effect of beta-lactamase synthesis was inhibited by the combination of amoxycillin with clavulanate, and by cefuroxime and ceftriaxone. Cefaclor was slightly less effective. Erythromycin, clarithromycin and azithromycin showed identical cross-resistance rates (around 10%). Resistance to the macrolides was more frequent in the USA than in Europe and was the sole trait found to increase during the survey. Doxycycline, chloramphenicol, co-trimoxazole and the two fluoroquinolones tested (ofloxacin and ciprofloxacin) were remarkably effective (resistance lower than 1%). Only doxycycline and, to a lesser extent, co-trimoxazole were partially active against methicillin-resistant strains.

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Stable flies (n = 180) were collected over 3 summer months and processed individually for STEC-8 that included the serotype O157 and seven non-O157 serotypes (O26, O45, O103, O104, O111, O121, and O145). Isolation and detection of STEC was based on direct plating as well as the enrichment/immunomagnetic separation approach. Modified Posse agar (mP) was used for culturing non-O157 serotypes and sorbitol MacConkey agar with cefixime and potassium tellurite (CT-SMAC) for E. coli O157. Multiplex polymerase chain reactions were used for differentiation of individual serotypes and detection of virulence genes (stx1, stx2, eae, and ehxA).

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An urban inner-city primary care clinic.

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Urinary tract infection is the second most common clinical indication for empirical antibiotic treatment in primary and secondary health care settings. The incidence of diabetes mellitus throughout the world is increasing strikingly and in the long run, it has some major effects on the genitourinary system which makes diabetic patients more liable to urinary tract infection. This study is designed to reveal the distribution of uropathogens in diabetic patients according to age and sex, and corresponding resistance patterns.

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To ascertain recommendations for the treatment of gonorrhoea in the WHO Western Pacific Region (WPR) following the emergence of "cephalosporin-resistant" Neisseria gonorrhoeae and to relate these to clinical and laboratory measures directed towards disease and antibiotic resistance control. WHO WPR Gonococcal Antimicrobial Resistance Programme members provided data on the type, dose and source of third-generation cephalosporins recommended for the treatment of gonorrhoea. Ceftriaxone was recommended more widely (11/15 respondents) than cefixime (five centres). No cephalosporins were recommended in three jurisdictions. One other oral (ceftibuten) and injectable (cefodizime) agent was recommended. Uniform (400 mg) doses of cefixime were recommended but ceftriaxone regimens ranged between 125 mg and 1 g, with nine of 11 respondents using a 250 mg dose. Both generic and proprietary preparations were widely used. Third-generation cephalosporins are widely recommended for the treatment of gonorrhoea in the WPR, with injectable ceftriaxone more extensively so than oral cefixime and in an expanded dose range. Few other cephalosporins were recommended. Current knowledge suggests that the trend towards ceftriaxone treatment in higher doses may decrease the impact of the circulation of "cephalosporin-resistant" gonococci in the WPR. These recommendations represent public sector practice only and of themselves are unlikely to contain the further spread of "cephalosporin-resistant" gonococci because of the general clinical use of cephalosporins. Optimisation of strategies for laboratory detection of third-generation cephalosporin resistance can be simplified in the WPR because of the restricted spectrum of cephalosporins recommended. Additional efforts are urgently required for both disease and antibiotic resistance control in gonorrhoea.

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To compare a range of enrichment broths and enrichment temperatures for the isolation of Escherichia coli O157 by immunomagnetic separation (IMS) from sandy, loam and clay soils.

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Descriptive data from the Gonococcal Resistance to Antimicrobials Surveillance Programme for England and Wales were analyzed to investigate patient characteristics associated with infection with susceptible isolates using univariate and multivariable analyses.

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Neisseria gonorrhoeae antimicrobial susceptibility is monitored in the European Union (EU) and the European Economic Area (EEA) by the European gonococcal antimicrobial surveillance programme (Euro-GASP). Results from 17 EU/EEA Member States in 2009 showed that 5% of isolates had decreased susceptibility to cefixime, an upward trend in the minimum inhibitory concentrations of ceftriaxone and a high prevalence of resistance to ciprofloxacin (63%)and azithromycin (13%). These results are of public health value and highlight the need for healthcare professionals to be aware of possible cefixime treatment failures. Euro-GASP is being implemented in additional EU/EEA Member States to achieve greater representativeness. In addition, Euro-GASP aims to set up a system which will allow biannual reporting of antimicrobial resistance in the EU/EEA, with a transition from centralised towards decentralised testing,and will link epidemiological data to laboratory data to enhance surveillance. The benefits of this approach include more timely detection of emerging trends in gonococcal resistance across the EU/EEA and the provision of a robust evidence base for informing national and European guidelines for therapy.

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A range of sensitivities exhibited by Escherichia coli O157 to cefixime and potassium tellurite are demonstrated. The sensitivity was shown by growth on cefixime tellurite sorbitol MacConkey agar and by the effect on the metabolic activity in glucuronate trimethylamine-oxide conductance broth. These antimicrobials are regularly used in the isolation of this pathogen from food and clinical specimens, and such sensitivity may lead to the reporting of false negative samples.

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The growth characteristics of 96 shiga toxin-producing Escherichia coli (STEC) strains representing 36 different O-types (including priority O types O26, O45, O103, O111, O121, O145 and O157) on commercial and in-house agar media were studied. The ability of the strains to grow on agar media with varying selective supplement formulations was evaluated using MacConkey Agar (MAC); Rainbow® Agar O157 (RBA); Rainbow® Agar O157 with manufacturer-recommended selective supplements (RBA-NT); Rainbow® Agar O157 with USDA-recommended selective supplements (RBA-USDA); CHROMagar STEC™ (CH STEC); Tryptone Bile agar containing cefixime and tellurite (TBA-CT); Tryptone Bile agar containing cefixime, tellurite, eosin and methylene blue (TBA-EM); and VTEC agar. All of the strains were able to grow on MAC, RBA and VTEC agar, whereas a number of strains (including some non-O157 priority O types) were unable to grow on the highly selective media CH STEC, RBA-NT, RBA-USDA, TBA-EM and TBA-CT. Only RBA-NT and CH STEC exhibited significant inhibition of background flora from ground beef enrichment. Significant inhibition of background flora from beef trim enrichment was observed with RBA-NT, RBA-USDA, CH STEC, TBA-EM and VTEC agar. With exception of E. coli O157, several different colony morphologies were observed on the differential plating media among strains of the same O type, indicating that this colony morphology is not a reliable means of identifying target STEC. These results suggest that an approach to maximize the recovery of target STEC from beef enrichment cultures is dual plating on lesser (RBA, MAC, VTEC agar) and more highly (RBA-NT, CH STEC) selective agars.

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Out of 220 food handlers, 209 consented to participate, and among them, 19 (9.1%) were positive for S. enterica serovars. Serotyping of these isolates showed that 9 (4.3%) were typhoidal S. serovars while 10 (4.7%) were non-typhoidal S. serovars. Of the typhoidal S. serovars, 7 were S. enterica serovar Typhi and 1 each of S. enterica serovar Paratyphi A and B. The resistance pattern of these isolates showed that 77.7% were resistant to ampicillin and 11.1% to cotrimoxazole. All typhoidal S. enterica serovar isolates were sensitive to chloramphenicol, ceftriaxone, cefixime, nalidixic acid, and ofloxacin.

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For the evaluation of plating and immunological methods applicable to the detection of Escherichia coli O157:H7 from ground beef and radish sprouts, a collaborative study was conducted. It focused on a comparison of the efficiency of the plating and immunological methods using various plating agars and immuno-kits in combination with enrichment in modified E. coli broth supplemented with novobiocin (mEC + n), and using immunomagnetic separation. The plating media tested were sorbitol MacConkey agar (SMAC), SMAC supplemented with cefixime (0.05 mg/l) and potassium tellurite (2.5 mg/l) (CT-SMAC), and agars containing beta-glucuronidase substrates such as BCM O157 and CHROMagar O157. The immuno-kits used were Now E. coli, Path-Stick O157, VIP, EHEC-Tek ELISA System and Rapiblot E. coli O157. The 20 participating laboratories attempted to detect E. coli O157:H7 in 25 g chilled and frozen samples of ground beef uninoculated and inoculated with E. coli O157:H7 at levels of 138.9 and 23.9 cfu/25 g, and in 25 g chilled and frozen samples of radish sprouts uninoculated and inoculated at levels of 20.4 and 1.7 cfu/25 g. E. coli O157:H7 was recovered well from ground beef by all of the methods except direct plating with SMAC. For radish sprouts, the IMS-plating methods with CT-SMAC, BCM O157 and CHROMagar O157 were most efficient at detecting E. coli O157:H7 in more than 90% of the chilled samples inoculated at the level of 20.4 cfu/25 g. All the methods were less sensitive when applied to similar levels of E. coli O157:H7 in radish sprouts (20.4 cfu/25 g) compared with ground beef (23.9 cfu/25 g) especially if the sprouts were frozen. The sensitivity of the immuno-kits appeared to be similar to the IMS-plating methods, but the specificity was lower. Based on the results, we recommend the IMS-plating method using CT-SMAC and agars containing beta-glucuronidase substrate in combination with static enrichment incubation in mEC + n at 42 degrees C.

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Antimicrobial resistance in Neisseria gonorrhoeae is an increasing problem worldwide and combinations of antimicrobial agents have been recommended to delay the onset of treatment failures. The objective of this study was to obtain in vitro data on the activity of current (ceftriaxone or cefixime plus azithromycin) and alternative (gentamicin plus azithromycin) regimens.

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Cefpodoxime proxetil is an orally administered prodrug which is absorbed and de-esterified by the intestinal mucosa to release the third generation cephalosporin, cefpodoxime. Cefpodoxime is stable towards the most commonly found plasmid-mediated beta-lactamases and the drug has a broad spectrum of antibacterial activity encompassing both Gram-negative and Gram-positive bacteria, rendering it a possible option for empirical use in a wide range of community acquired infections in both adult and paediatric patients. The extended plasma half-life of cefpodoxime (1.9 to 3.7 h) permits twice daily administration. In comparative trials, twice daily cefpodoxime proxetil (dose equivalent cefpodoxime 100 to 400 mg) was as effective as a 3- to 4-times daily regimen of phenoxymethylpenicillin in pharyngotonsillitis, as well as thrice daily amoxicillin (with or without clavulanic acid) or cefaclor against infections of the ear, the upper and lower respiratory tract, the urinary tract and those of the skin and soft tissues. The latter reflects the enhanced antistaphylococcal activity of cefpodoxime, which distinguishes it from other orally active third generation cephalosporins such as cefixime. Most notably, an oral regimen of cefpodoxime proxetil was as efficacious as parenterally administered ceftriaxone for the treatment of bronchopneumonia in hospitalised patients at risk due to the presence of underlying diseases, addictions or advancing age. A single oral dose of cefpodoxime was also as efficacious as ceftriaxone in uncomplicated anogenital gonococcal infections. Cefpodoxime proxetil is generally well tolerated, with mild to moderate gastrointestinal disturbances occurring in 4 to 15% of patients treated with therapeutic doses. Thus, a convenient twice daily oral regimen of cefpodoxime proxetil can be prescribed as an effective alternative to established beta-lactam therapies in the empirical outpatient treatment of infections of the respiratory and urinary tracts as well as those of the skin and soft tissues.

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The study was carried out to investigate the incidence of Escherichia coli O157 in raw materials, foodstuffs and the agricultural environment. Of a total of 987 samples examined, 22 strains (2.2%) were identified as E. coli O157 and 10 of them as E. coli O157:H7. Cefixime-Tellurite MacConkey sorbitol agar (CT-SMAC) agar and Biosynth culture medium (BCM) E. coli O157:7 medium were used for the isolation. The virulence factors (stx1, stx2, eae, and ehxA genes) were identified by polymerase chain reaction (PCR). Most strains were isolated from the mechanically deboned poultry meat (nine), minced meat (six) and raw milk (four). One strain was isolated from beef carcass and two strains from waste water. No strains were were found in mass for sausages, refreshment salads, swabs of pork and poultry carcasses and faeces of cattle and pigs. Ten strains from the 22 identified proved to be positive for all factors of virulence. They were isolated from minced meat (four), raw milk (four), waste water (one) and swab from beef carcass (one). Sensitivity to the antimicrobial drugs ampicillin (AMS), ampicillin-sublactam (SAM), tetracycline (TET), ofloxacine (OFL), cefuroxime (CRX), chloramphenicol (CPM), gentamicine (GEN), colistin (COL), cephalozine (CLZ), cefoxitin (CXT), aztreonam (AZT), and sulphamethoxazole + trimethoprim (COT) was tested using the standard dilution technique and disc diffusion test. Minimum inhibitory concentrations (MIC) characteristics (MIC(50), MIC(90), MIC range) and inhibitory zone diameter were determined for each strain. As determined by MICs, the resistance to tested antibiotics in E. coli O157 isolates was found to AMS (90.9%), CLZ (81.8%), CRX (63.6%), CXT (72.7%), CPM (72.7%), TET (81.8%), SAM (59.1%), COT (9.1%), COL (63.61%), AZT (9%) and GEN (4.5%). The similar results were obtained using the disc diffusion method. The differences were found relating to SAM, CXT, CMO and TET. Resistance against one or more antibiotics was found in 95.4% of E. coli O157. Only one strain was susceptible to all tested antibiotics. Most of the strains were resistant to ampicillin and cephalozine. Eight different resistance phenotypes were demonstrated in E. coli O157.

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In children with high proportions of nalidixic acid-resistant strains, older fluoroquinolones increased clinical failures compared with azithromycin (OR 2.67, 95% CI 1.16 to 6.11; 125 participants, 1 trial), with no differences using newer fluoroquinolones (285 participants, 1 trial). Fluoroquinolones and cefixime were not statistically significantly different (82 participants, 1 trial). Trials comparing different durations of fluoroquinolone treatment were not statistically significantly different (889 participants, 9 trials). Norfloxacin had more clinical failures than other fluoroquinolones (417 participants, 5 trials).

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Canada conducts surveillance of penicillin, tetracycline, erythromycin, spectinomycin, ciprofloxacin, cefixime, and ceftriaxone susceptibilities in Neisseria gonorrhoeae isolates to support development of national treatment guidelines for sexually transmitted infections.

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To evaluate care delivery patterns in patients treated for pelvic inflammatory disease in pediatric outpatient settings and to determine the effect of practice type on care delivery.

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cefixime generic name 2015-05-13

The prevalence of E. coli O157:H7 buy cefixime in industrial French minced beef was 0.12%, consistent with many other reports.

cefixime drug interactions 2016-08-17

The only current CDC-recommended options for treating Neisseria gonorrhoeae infections are from a single class of antibiotics, the cephalosporins. Within this class, ceftriaxone, available only as an injection, is the recommended treatment for all types of gonorrhea infections (i.e., urogenital, rectal, and pharyngeal). The only oral agent recommended currently by CDC for treatment of uncomplicated urogenital or rectal gonorrhea is a buy cefixime single dose of cefixime 400 mg. Availability of cefixime had been limited since July 2002, when Wyeth Pharmaceuticals (Collegeville, Pennsylvania) discontinued manufacturing cefixime tablets in the United States. Beginning in April 2008, cefixime (Suprax) 400 mg tablets are again available in the United States.

cefixime 400 dosage 2016-03-23

In this open, randomized and controlled multicenter study involving a total of 100 hospitalized patients with infections of the lower respiratory tract, including pneumonia, the efficacy and tolerability of sequential treatment with cefotaxime i.v./cefixime oral were compared with those of exclusively parenteral treatment with cefotaxime. The patients received either 2 x 2 g cefotaxime i.v. over a period of 7 to 10 days, or 2 x 2 g cefotaxime over a period of 48 to 72 hours followed by oral cefixime treatment (1 x 400 mg/day) for a further 5 to 8 days. buy cefixime

cefixime capsules dosage 2017-08-08

Antimicrobial susceptibilities of 244 amoxycillin-non-susceptible and 81 amoxycillin-susceptible pneumococcal isolates from 15 Spanish hospitals were determined and clonal relationships were investigated by pulsed-field gel electrophoresis after SmaI restriction. Amoxycillin-non-susceptible isolates exhibited higher rates of resistance to cefuroxime, cefixime, cefpodoxime and clarithromycin, but not to levofloxacin and cefotaxime. Cefditoren exhibited MIC(90) values one dilution lower than those of cefotaxime. Higher numbers of the Spain(14)-5 and Spain(6B)-2 clones, but not the Spain(9V)-3 and Spain(23F)-1 clones, were found among amoxycillin-non-susceptible isolates. Spain(14)-5 was the most problematic clone in terms of buy cefixime antibiotic resistance.

cefixime 200mg capsule 2015-09-09

The pharmacokinetic profile of FK482 was studied in mice, rats, rabbits and dogs after oral dosing and compared with that of cefixime, cefaclor and cephalexin. Considerable differences in oral absorption of buy cefixime FK482 were observed among the animal species. Absolute bioavailabilities of FK482 were 12.6% in mice, 15.3% in rats, 32.3% in rabbits and 72.3% in dogs. In mice and rats, the absorption of FK482 was poor, and was the lowest of the reference antibiotics. FK482 was moderately well absorbed, with higher plasma levels than cefixime in rabbits and, like cefixime, gave higher plasma levels and a longer half-life than cefaclor or cephalexin in dogs. The increase in the area under the serum concentration time curve (AUC) of FK482 was strictly proportional to the increase in dose in the range of 2.5 to 40 mg/kg in rats and dogs, and 2.5 to 20 mg/kg in rabbits and the urinary recovery rates were almost constant. All tissue concentrations of FK482 in rats and rabbits were lower than those of the reference antibiotics and reflected its lower plasma concentrations in these animals. The urinary recovery rates of FK482 were 9.8% for mice, 15.5% for rats, 45.8% for rabbits and 47.1% for dogs. The biliary recovery rate of FK482 was low; 1.4% in rats and less than 0.1% in rabbits and dogs. No active metabolites were detected in the plasma, urine or bile samples from rats, rabbits or dogs. FK482 was mainly absorbed in the jejunum, and was inactivated in the large intestine. The serum-protein binding of FK482 was almost the same as that of cefixime: 60-77% for mouse, rabbit and human serum, and 90-93% for rat and dog serum.

cefixime 200mg tablet 2015-05-11

BK-218 is a buy cefixime novel cephalosporin with a dual route of administration and spectrum of activity most similar to that of second-generation cephalosporins. BK-218 was active against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis but strains resistant to penicillins had higher MICs. BK-218 had greater activity (8-fold) than cefuroxime or cefaclor against oxacillin-susceptible Staphylococcus spp. Moderate BK-218 activity was observed against Neisseria gonorrhoeae and commonly isolated Enterobacteriaceae such as Escherichia coli (MIC90, 1 mg/l), Klebsiella spp. (MIC90, 2 mg/l), and Proteus mirabilis (MIC90, 2 mg/l). The following organisms were generally BK-218-resistant (MIC90, greater than 16 mg/l): Bacteroides fragilis, Pseudomonas spp., Acinetobacter spp., Xanthomonas maltophilia, Citrobacter spp., Enterobacter spp., indole-positive Proteus, Serratia spp., enterococci and oxacillin-resistant staphylococci.

cefixime syrup 2017-06-07

In 2009, the first high-level ceftriaxone-resistant Neisseria gonorrhoeae strain (H041) was isolated in Kyoto, Japan. The present study describes an intensified surveillance (antimicrobial resistance and molecular typing) of Neisseria gonorrhoeae isolates in Kyoto and its neighboring prefecture Osaka, Japan, in 2010 to 2012, which was initiated after the identification of H041. From April 2010 to buy cefixime March 2012, 193 N. gonorrhoeae isolates were collected and the MICs (μg/ml) to six antimicrobials, including ceftriaxone, were determined. All isolates showed susceptibility to ceftriaxone and cefixime (MIC values, <0.5 μg/ml), and spectinomycin. The rates of resistance (intermediate susceptibility) to azithromycin, penicillin G, and ciprofloxacin were 3.6% (19.7%), 24.4% (71.0%), and 78.2% (0.5%), respectively. Multilocus sequence typing (MLST) showed that 40.9%, 19.2%, and 17.1% of isolates belonged to ST1901, ST7359, and ST7363, respectively. Furthermore, N. gonorrhoeae multiantigen sequence typing (NG-MAST) revealed that 12 (63%) of the 19 isolates with decreased susceptibility to ceftriaxone (MIC > 0.064 μg/ml) were of ST1407. NG-MAST ST1407 was also the most prevalent ST (16.1%; 31 of 193 isolates). In those NG-MAST ST1407 strains, several mosaic type penA alleles were found, including SF-A type (penicillin binding protein 2 allele XXXIV) and its derivatives. These were confirmed using transformation of the penA mosaic alleles as critical determinants for enhanced cefixime and ceftriaxone MICs. The intensified surveillance in Kyoto and Osaka, Japan, did not identify any dissemination of the high-level ceftriaxone-resistant N. gonorrhoeae strain H041, suggesting that H041 might have caused only a sporadic case and has not spread further.

cefixime 75 mg 2016-01-29

Treatment failures following therapy with the oral third-generation cephalosporins cefixime and ceftibuten have been reported, but not with the injectable ceftriaxone. The gonococci involved have raised minimal inhibitory concentrations to these agents, including to ceftriaxone. The presence buy cefixime of multiple chromosomal changes form the basis for this 'resistance', prominent among which is a mosaic penicillin-binding protein 2 found in association with additional known and unknown mutations in other genes. The imprecise nature of laboratory criteria for detecting these gonococci means that the distribution and prevalence of these strains is also uncertain.

cefixime capsules dissolution 2015-10-28

Oral cefixime or ceftriaxone injections were used as first-line drugs for the treatment of gonorrhea from 2006 to 2013 because gonorrhea isolates had low minimum inhibitory concentrations for these two drugs. The abrupt emergence of ST4378 (closely related to the notorious ST1407) since 2009 is a cause for alarm. Changes in sexual behavior, including an increase in sexual activity without the use of condoms, may have contributed to the peak in gonorrhea buy cefixime in 2010. Further molecular epidemiological investigations are required.

cefixime recommended dose 2017-03-22

Acute otitis media (AOM) is common in Indian children, but there is limited published information on its clinic prevalence, clinicians' diagnostic practices, and their management strategies. We approached 649 ear-nose-throat (ENT) surgeons to assess these aspects of AOM. We conducted the survey between May 2010 and February 2011 with the same set of ENT surgeons practising across India, once each during summer, monsoon and winter, using a validated 36-item questionnaire to record their reflective recall. 78 % (506/649) of approached ENT surgeons responded. The clinic prevalence of AOM was 43 % with peaks reported in July and December. 96 % (486/506) of the surgeons used otoscopy to diagnose AOM. 86 % (435/506) prescribed analgesics, and 89 % (449/506) prescribed decongestants. 98 % (495/506) treated AOM with an antibiotic at initial consultation: amoxicillin/clavulanic acid 78 % (395/506), amoxicillin 29 % (144/506), cefpodoxime 29 % (149/506), cefixime 28 % (141/506) and azithromycin 27 % (134/506). Amoxicillin/clavulanic acid 32 % (162/506) and cefpodoxime 27% (137/506) were mostly prescribed for relapse. The average reported duration of initial antibiotic therapy was 7 days and for relapse was 9 days. The reported clinic prevalence of AOM was higher (43 %) than anticipated (about 10 %) in ENT buy cefixime practice. Almost all the ENT surgeons used an otoscope to diagnose AOM. Amoxicillin/clavulanic acid was the preferred antibiotic for treating AOM either initially or for relapse. Most surgeons also used analgesics and decongestants for symptomatic relief.

cefixime dosing pediatrics 2017-04-17

This study compared the antimicrobial susceptibility and genotypes of strains of Neisseria gonorrhoeae isolated from men who have sex with men (MSM) and from heterosexuals. One hundred and eleven strains were characterized from 107 patients, comprising 57 strains from 54 heterosexuals and 54 strains from 53 MSM. Antimicrobial resistance rates were higher in strains from heterosexual patients, with resistance to cefixime (P = 0·0159) and ciprofloxacin (P = 0·002) being significantly higher. Typing by N. gonorrhoeae multi-antigen sequence typing (NG-MAST) showed that the most prevalent sequence types (ST) and genogroups (G) respectively were ST2400, ST2992, and ST5793, and G1407, G2992, and G2400. A statistically significant association was observed for MSM and genogroups G2400 (P = 0·0005) and G2992 (P = 0·0488), and G1407 with heterosexuals buy cefixime (P = 0·0002). We conclude that in our region distinct populations of gonococci are circulating among subjects with different sexual practices, with their corresponding transmission patterns. Furthermore, the high prevalence of genotype G2400 in MSM, has not to our knowledge been previously described.

cefixime gonorrhea dosage 2015-12-21

The need for biological data on the susceptibility of Neisseria gonorrhoeae in Kyrghyzstan, to enable adaptation of the national treatment protocol for gonococcal infections, led Médecins Sans Frontières and Epicentre to conduct a survey in collaboration with the Alfred Fournier Institute in Paris and the health authorities in buy cefixime Bishkek.

cefixime 400mg capsule 2015-09-12

Our results demonstrate that mixed populations of E. coli O157 buy cefixime with distinguishable PFGE profiles that are simultaneously present in bovine faeces can be isolated with IMS/CT-SMAC technique.

cefixime dispersible tablets 2015-06-24

Sixty five Neisseria gonorrhoeae strains isolated from patients of the Department of Dermatology and Venereology in Warsaw in the second half of 2012 and first of 2013 were investigated. The strains were cultured on chocolate agar plates in a 5% CO2 atmosphere at 37 °C and identified by colony morphology, Gram staining and oxidase reaction, followed by carbohydrate utilization test. Azithromycin susceptibility was determined by E-Tests (bioMerieux). Bacteria were incubated at 37°C in buy cefixime 5% CO2 for 24 h on chocolate agar plates. Tests were performed according to producers recommendations. The results (sensitive or resistant) were interpreted according to EUCAST recommendations.

cefixime tablet uses 2016-09-06

To Diovan Dosage determine which mutations in penA, mtrR and porB are implicated in increasing minimum MICs of ceftriaxone and cefixime in a susceptible gonococcal population and to ascertain associations with gonococcal strain types (STs).

cefixime dosage 200mg 2015-03-17

An increase in Haemophilus influenzae resistance has been documented around the world during the last 30 years. Resistance is due to the production of beta-lactamases, and/or changes to penicillin-binding protein (PBP) targets. The resistance problem has led to the need for new therapeutic strategies aimed at maintaining effective management of both upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs). Among antimicrobial agents tested, third-generation cephalosporins have been shown to possess excellent in vitro activity against beta-lactamase-positive and -negative isolates, corresponding with proven clinical efficacy in a wide range of RTIs. The role of H. influenzae in RTIs is outlined, changing trends in epidemiological Precose Patient Review surveillance studies monitored and implications for therapy, based upon results of clinical trials discussed.

cefixime 300 mg 2015-04-11

Patients with clinically diagnosed uncomplicated enteric fever meeting the inclusion Seroquel Overdose Emedicine criteria.

cefixime dose uses 2015-10-06

The attack rate was 31 in 104. Two children developed HUS. There were higher attack rates among girls and friends who played together. Cases were more likely to attend the nursery more frequently. The mean number of recorded bowel motions/child/half day was 0.51 in cases and 0.21 in Cytoxan Oral Medication well children. Child to staff ratios were high preceding and during the outbreak.

cefixime 30 mg 2016-12-13

To assess the effect of pooling fecal samples on the sensitivity of detection of E. coli O157:H7, 12 calves, inoculated orally with 10(8)cfu per calf of nalidixic acid resistant E. coli O157:H7, were used to provide positive fecal samples. After inoculation, calves were sampled twice weekly. Negative fecal samples were from calves at a local dairy. Samples from inoculated calves were incubated without pooling or were mixed with known negative fecal samples in a 1:4 ratio or a 2:3 ratio (positive:negative) for detection of E. coli O157:H7. Samples were enriched 6h in Gram negative broth with vancomycin, cefixime, and cefsoludin, underwent immunomagnetic separation with Dynabeads, and were plated onto sorbitol MacConkey agar with cefixime, and tellurite (SMACct). Morphologically typical colonies were plated onto blood agar, incubated overnight at 37 degrees C and an indole test was performed on each colony. Indole positives colonies were plated on SMAC agar with 20 microg Glucotrol Max Dose /ml nalidixic acid (SMACnal). Colonies that grew on SMACnal were confirmed by O157 agglutination. Sensitivity of detection in non-pooled samples was 77%. Samples pooled 1:4 and 2:3 with negative samples were 55 and 52% sensitive, respectively. Pooling decreased sensitivity of detection for E. coli O157:H7 in bovine fecal samples (P<0.01). A deterministic binomial probability model was developed to assess the probability of detecting pens of cattle shedding E. coli O157 using a pooling protocol or individual samples. Pooling decreased sensitivity of detection at low pen prevalence compared to individual samples but was similar at high prevalence.

cefixime buy online 2015-02-27

Gonorrhoea and widely spread antimicrobial resistance (AMR) in its etiological agent Neisseria gonorrhoeae are major public health concerns worldwide. Gonococcal AMR surveillance nationally and internationally, to identify emerging resistance and inform treatment guidelines, is imperative for public health purposes. In 2009, AMR surveillance was initiated in Belarus, Eastern Europe because no gonococcal AMR data had been available for at least two decades. Herein, the prevalence and trends of gonococcal AMR and molecular Reglan Dosing Information epidemiological characteristics of N. gonorrhoeae strains from 2010 to 2013 in Belarus, are described.