Suprax: Potent Cephalosporin Antibiotic for Bacterial Infections
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Synonyms | |||
Suprax (cefixime) is a third-generation oral cephalosporin antibiotic renowned for its broad-spectrum bactericidal activity. It exerts its effect by inhibiting bacterial cell wall synthesis, leading to the eradication of susceptible pathogens. This medication is a cornerstone in outpatient treatment for a variety of community-acquired infections, offering the convenience of once-daily dosing which supports patient adherence. Its stability against beta-lactamases extends its utility against strains that may resist older antibiotics, making it a reliable choice for clinicians managing respiratory, urinary tract, and ENT infections in both adult and pediatric populations.
Features
- Active pharmaceutical ingredient: Cefixime
- Pharmacologic class: Third-generation cephalosporin antibiotic
- Administration: Oral (tablets, chewable tablets, oral suspension)
- Standard dosing regimen: Typically once or twice daily, independent of meals
- Broad-spectrum activity against Gram-positive and Gram-negative bacteria
- Demonstrated stability against many beta-lactamase enzymes
- Available in multiple strengths for precise dosing across age groups
Benefits
- Effectively treats a wide range of common bacterial infections, reducing the need for multiple medications.
- Once-daily dosing regimen enhances convenience and improves patient compliance with the treatment course.
- Proven clinical efficacy in eradicating susceptible pathogens, leading to rapid symptom resolution.
- Generally well-tolerated profile in both adult and pediatric patients over six months of age.
- Oral formulation eliminates the need for injections in many cases, facilitating outpatient treatment.
- Provides a reliable therapeutic option for infections where first-line antibiotics may be unsuitable due to resistance or allergy.
Common use
Suprax is indicated for the treatment of infections caused by susceptible strains of designated microorganisms. Its common uses include uncomplicated urinary tract infections (e.g., cystitis) caused by Escherichia coli and Proteus mirabilis. It is also frequently prescribed for otitis media (middle ear infection) caused by Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes. Furthermore, it is used for pharyngitis and tonsillitis attributable to Streptococcus pyogenes, as an alternative for penicillin-allergic patients. It is effective in treating acute bronchitis and acute exacerbations of chronic bronchitis caused by Streptococcus pneumoniae and Haemophilus influenzae (non-beta-lactamase producing strains). Uncomplicated gonorrhea (cervical/urethral) caused by Neisseria gonorrhoeae is another established indication.
Dosage and direction
Dosage is based on the type and severity of the infection, as well as the patient’s age and renal function. It can be administered with or without food.
- Adults and children ≥12 years or ≥50 kg: The standard dose for most infections is 400 mg daily, administered as a single 400 mg tablet or 20 mL (400 mg) of suspension. For the treatment of uncomplicated gonorrhea, a single 400 mg oral dose is recommended.
- Pediatric patients (6 months to 12 years or <50 kg): The recommended dose is 8 mg per kg of body weight per day. This can be administered as a single daily dose or divided and given every 12 hours. Dosing is based on the child’s weight using the oral suspension (100 mg/5 mL).
- Renal Impairment (Creatinine Clearance <60 mL/min): Dosage adjustment is required. A maximum daily dose of 300 mg is recommended for patients with significant renal impairment. Dosing intervals may also be extended.
- The oral suspension must be shaken well before each use. Use the measuring device provided to ensure accurate dosing.
- Complete the entire prescribed course of therapy, even if symptoms disappear after a few days, to prevent the development of antibiotic-resistant bacteria.
Precautions
- Prescribing Suprax in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit and increases the risk of developing drug-resistant bacteria.
- Use with caution in patients with a history of gastrointestinal disease, particularly colitis, as antibiotic use can cause pseudomembranous colitis.
- As with other broad-spectrum antibiotics, prolonged use may result in the overgrowth of non-susceptible organisms, including fungi. If superinfection occurs during therapy, appropriate measures should be taken.
- Caution is advised in patients with impaired renal function; dosage adjustments are necessary.
- Should be prescribed with caution to patients with a history of hypersensitivity reactions to penicillins or other drugs, as cross-sensitivity among beta-lactam antibiotics has been documented.
- False-positive reactions for glucose in the urine may occur with Benedict’s or Fehling’s solutions or with Clinitest® tablets.
Contraindications
Suprax is contraindicated in patients with known hypersensitivity to cefixime, any other cephalosporin-class antibiotic, or any component of the formulation.
Possible side effect
As with all medicines, Suprax can cause side effects, although not everybody gets them. Most are generally mild to moderate and transient.
- Gastrointestinal: Diarrhea (most common), nausea, abdominal pain, dyspepsia, flatulence, vomiting. Diarrhea may be a symptom of pseudomembranous colitis.
- Central Nervous System: Headache, dizziness.
- Dermatological: Rash, urticaria (hives), pruritus (itching).
- Hepatic: Transient elevations in hepatic enzymes (ALT, AST, Alkaline Phosphatase).
- Renal: Transient elevations in blood urea nitrogen (BUN) and serum creatinine.
- Hematological: Transient thrombocytopenia, leukopenia, and eosinophilia have been reported.
- Other: Genital pruritus, vaginitis.
Patients should be advised to contact their physician if severe, watery diarrhea or bloody diarrhea develops.
Drug interaction
- Carbamazepine: Concomitant administration may result in increased plasma concentrations of carbamazepine, potentially leading to toxicity. Carbamazepine levels should be monitored.
- Warfarin: Cephalosporins may potentiate the anticoagulant effects of warfarin and other oral vitamin K antagonist anticoagulants. Prothrombin time should be monitored closely.
- Nifedipine: Concomitant administration can increase the bioavailability of cefixime.
- Probenecid: Concomitant use may lead to increased and prolonged blood levels of cefixime by inhibiting renal tubular secretion.
Missed dose
If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not take a double dose to make up for a missed one.
Overdose
Gastric lavage may be indicated in cases of significant overdose. Symptoms of overdose are likely to be consistent with the adverse reaction profile, primarily nausea, vomiting, and diarrhea. Cefixime is not removed in significant quantities from the circulation by hemodialysis or peritoneal dialysis. Medical supervision and supportive care are recommended.
Storage
- Store tablets at controlled room temperature, 20°-25°C (68°-77°F), in a tight, light-resistant container.
- The dry powder for oral suspension should be stored between 2°-25°C (36°-77°F) prior to reconstitution.
- After reconstitution with water, the oral suspension must be stored in the refrigerator (2°-8°C / 36°-46°F). Do not freeze.
- Keep the tightly closed bottle of reconstituted suspension and discard any unused portion after 14 days.
- Keep all medications out of the reach of children and pets.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The content has not been evaluated by all regulatory agencies and is intended for an expert audience.
Reviews
(Note: As a prescription medication, individual reviews are not typically aggregated in a commercial context. Clinical efficacy and safety are established through rigorous clinical trials and post-marketing surveillance.)
- Clinical Consensus: Suprax is widely regarded by the medical community as a highly effective and convenient oral antibiotic for its approved indications. Its broad spectrum and once-daily dosing make it a valuable tool in outpatient management.
- Prescriber Feedback: Healthcare professionals appreciate its utility in treating common infections, particularly in penicillin-allergic patients (with appropriate caution), and its generally favorable tolerability profile in pediatric populations.
- Formulary Status: It is a commonly included antibiotic on hospital and managed care formularies due to its proven efficacy, safety record, and cost-effectiveness for targeted therapeutic uses.