Cefixime
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Cefixime is an oral third-generation cephalosporin antibiotic used to treat a range of bacterial infections, including urinary tract infections, otitis media, pharyngitis, and uncomplicated gonorrhea. It is notable for being one of the few orally bioavailable third-generation cephalosporins and offers broad activity against many Gram-negative organisms. Its use in gonorrhea is now limited because of widespread reduced susceptibility of Neisseria gonorrhoeae.
Exploratory record, not a reviewed medical publication.
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What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Cefixime is an oral third-generation cephalosporin antibiotic used to treat a range of bacterial infections, including urinary tract infections, otitis media, pharyngitis, and uncomplicated gonorrhea. NutriStack rates the supporting evidence as strong. Common adult dosing is 400 mg once daily or 200 mg twice daily for most infections; for uncomplicated gonorrhea, a single 800 mg oral dose (CDC alternative regimen, with caution due to resistance), though a prescriber sets the actual dose. With long-term use it can deplete vitamin k. This profile indexes 3 sources.
The bottom line
Evidence rating strong. Most-documented uses: uncomplicated urinary tract infections, acute otitis media, pharyngitis and tonsillitis caused by streptococcus pyogenes. 3 sources indexed (1989–2021), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Cefixime is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to and inactivating penicillin-binding proteins (PBPs), which are transpeptidase enzymes responsible for cross-linking peptidoglycan strands in the bacterial cell wall. Disruption of cross-linking weakens the cell wall and leads to autolysis and bacterial death. As a third-generation cephalosporin, cefixime is relatively stable against many beta-lactamases and has enhanced activity against Gram-negative bacteria compared with earlier generations, though it has limited activity against Pseudomonas aeruginosa, staphylococci, and enterococci.3,1
Dosing & protocol.
Cefixime can be taken with or without food; food does not clinically meaningfully impair absorption, though taking with food may modestly delay peak levels. Oral bioavailability is approximately 40-50 percent. The suspension formulation produces higher peak serum levels than tablets and is preferred when treating otitis media.
What it depletes.
Nutrients this medication can lower over time, and what to replace.
Vitamin K
MildBroad-spectrum cephalosporins suppress colonic bacteria (notably Bacteroides species) that synthesize menaquinones (vitamin K2), reducing the endogenous vitamin K pool available for hepatic clotting-factor carboxylation. Unlike cephalosporins bearing an N-methylthiotetrazole (NMTT) side chain, cefixime does not directly inhibit vitamin K epoxide reductase, so the effect is mediated chiefly through gut-flora disruption and is usually clinically meaningful only with prolonged courses, poor dietary intake, or concurrent warfarin therapy.
Full safety detail.
Side effects
- Diarrhea (most common)
- Abdominal pain and nausea
- Flatulence and dyspepsia
- Headache and dizziness
- Rash and pruritus
- Vaginal candidiasis
- Clostridioides difficile-associated diarrhea (including pseudomembranous colitis)
- Rare hypersensitivity reactions including anaphylaxis and Stevens-Johnson syndrome
Contraindications
- Known hypersensitivity to cefixime or other cephalosporins2,1
- History of severe immediate hypersensitivity (anaphylaxis) to penicillins or other beta-lactams (use with caution due to cross-reactivity)
- Use caution in patients with significant renal impairment (dose adjustment required for creatinine clearance below 60 mL/min)
- History of cephalosporin-associated colitis3
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Reviews & position papers
2- 1Sexually Transmitted Infections Treatment GuidelinesWorkowski KA, Bachmann LH, et al. · MMWR Recommendations and Reports (CDC) · 2021
Ceftriaxone is the preferred treatment for gonorrhea; cefixime 800 mg orally is an alternative only when ceftriaxone is not an option, due to declining gonococcal susceptibility to cefixime.
- 2Cefixime: A Review of its Antibacterial Activity, Pharmacokinetics and Therapeutic PotentialBrogden RN, Campoli-Richards DM · Drugs · 1989
Cefixime demonstrated clinical and bacteriological efficacy comparable to other agents in urinary, respiratory, and ear-nose-throat infections, with a once- or twice-daily dosing advantage from its long half-life.
Reference material
1- 3Suprax (cefixime) Prescribing InformationLupin Pharmaceuticals · US FDA Label · 2017
Cefixime is bactericidal through inhibition of cell wall synthesis, with activity against many Gram-negative organisms and oral bioavailability of about 40-50 percent.
Common questions.
Quick answers about Cefixime, drawn from the data on this page.
What is Cefixime?
Cefixime is an oral third-generation cephalosporin antibiotic used to treat a range of bacterial infections, including urinary tract infections, otitis media, pharyngitis, and uncomplicated gonorrhea. It is notable for being one of the few orally bioavailable third-generation cephalosporins and offers broad activity against many Gram-negative organisms. Its use in gonorrhea is now limited because of widespread reduced susceptibility of Neisseria gonorrhoeae.
What is Cefixime used for?
Commonly cited benefits of Cefixime include: Uncomplicated urinary tract infections; Acute otitis media; Pharyngitis and tonsillitis caused by Streptococcus pyogenes; Acute bronchitis and acute exacerbations of chronic bronchitis; Uncomplicated gonorrhea (alternative regimen when ceftriaxone unavailable). NutriStack rates the overall evidence as strong.
What is a typical dose of Cefixime?
A typical adult dose of Cefixime is 400 mg once daily or 200 mg twice daily for most infections; for uncomplicated gonorrhea, a single 800 mg oral dose (CDC alternative regimen, with caution due to resistance). The commonly recommended form is Oral tablet, capsule, or oral suspension. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Cefixime?
Reported side effects include diarrhea (most common), abdominal pain and nausea, flatulence and dyspepsia, headache and dizziness, rash and pruritus, vaginal candidiasis. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Cefixime?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Cefixime in NutriStack.
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