Cefixime + Clavulanic Acid is a fixed-dose combination of a third-generation cephalosporin antibiotic (Cefixime) and a beta-lactamase inhibitor (Clavulanic Acid). Cefixime acts by inhibiting bacterial cell wall synthesis, while Clavulanic Acid extends its spectrum by irreversibly inhibiting a wide range of beta-lactamase enzymes produced by resistant bacteria, particularly those inactivating cephalosporins. This combination is specifically designed to overcome beta-lactamase-mediated resistance, making it effective against a broader range of pathogens, including many resistant strains common in the Indian clinical setting.
Adult: One tablet (Cefixime 200mg + Clavulanic Acid 125mg) every 12 hours. For severe infections or less susceptible organisms, the dose can be increased to one tablet every 8 hours, as per physician discretion.
Note: Can be taken with or without food. Taking with food may minimize potential gastrointestinal upset. The tablet should be swallowed whole with a full glass of water. Do not crush or chew. Complete the full prescribed course even if you feel better.
Cefixime binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding inhibits the final transpeptidation step of peptidoglycan synthesis in the bacterial cell wall, leading to the formation of defective cell walls and osmotically unstable cells, resulting in cell lysis and death (bactericidal action). Clavulanic Acid has weak intrinsic antibacterial activity but possesses a high affinity for and irreversibly binds to a wide variety of beta-lactamase enzymes (e.g., TEM-1, SHV-1, and some plasmid-mediated enzymes). This binding 'suicidally' inactivates the enzymes, protecting Cefixime from hydrolysis and extending its spectrum to include beta-lactamase-producing strains.
Pregnancy: Pregnancy Category B. Animal studies have shown no direct harm, but adequate and well-controlled studies in pregnant women are lacking. Should be used only if clearly needed, after assessing benefit vs. risk. Cefixime crosses the placenta.
Driving: May cause dizziness. Patients should be cautioned about operating machinery or driving if they experience dizziness.
| Warfarin and other Coumarin Anticoagulants | Cefixime may potentiate anticoagulant effect, increasing risk of bleeding. Monitor INR closely. | Major |
| Aminoglycosides (e.g., Gentamicin) | Increased potential for nephrotoxicity. Monitor renal function. | Moderate |
| Probenecid | Inhibits renal tubular secretion of cefixime, leading to increased and prolonged blood levels of cefixime. | Moderate |
| Oral Contraceptives | Potential reduction in contraceptive efficacy due to altered gut flora. Advise use of a non-hormonal backup method. | Moderate |
| Antacids containing Aluminum/Magnesium | May reduce the absorption rate of cefixime, leading to lower peak levels. Administer at least 2 hours apart. | Minor |
| Chloramphenicol | Antagonistic effect; chloramphenicol is bacteriostatic and may interfere with the bactericidal action of cefixime. Avoid concurrent use. | Major |
Same composition (Cefixime (200mg) + Clavulanic Acid (125mg)), different brands: