Effects of cefixime: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Key Research Findings

Cefixime is a commonly used cephalosporin antibiotic, found to be effective in treating bacterial infections. However, studies suggest that cefixime can negatively impact the gut microbiome and worsen respiratory inflammation. 23 Cefixime was observed to alter the gut microbiome, decreasing the number of beneficial bacteria like Bifidobacterium and Lactobacillus, while increasing the number of potentially harmful bacteria like Enterococcus and Candida. 23 Moreover, cefixime was found to contribute to the worsening of Streptococcus pneumoniae infections, leading to increased lung inflammation. 23 This effect is believed to be due to cefixime disrupting the balance of the gut microbiome, which in turn negatively affects the lung’s endothelial barrier function. 23 Notably, these negative effects can be partly mitigated by administering probiotics like Bifidobacterium bifidum. 23

Cefixime may have a smaller impact on the gut microbiome compared to other cephalosporin antibiotics. 1 Research suggests that cefixime causes less significant changes in the composition of the gut microbiome compared to antibiotics like cefuroxime and cefuroxime axetil. 1

In vitro studies have shown that cefixime is effective against common urinary tract infection-causing bacteria like Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis. 21

Benefits and Risks

Benefit Summary

Cefixime has been shown to be effective in treating bacterial infections, particularly those caused by Streptococcus pneumoniae and urinary tract infections. 9 21 Additionally, cefixime may cause less disruption to the gut microbiome compared to other cephalosporin antibiotics. 1

Risk Summary

Cefixime has been linked to disrupting the gut microbiome balance, which may lead to worsening respiratory inflammation. 23 Additionally, cefixime may contribute to the emergence of antibiotic-resistant bacteria. 15

Comparison Across Studies

Similarities

Many studies show that cefixime is effective in treating bacterial infections. 9 21 A common finding across multiple studies is that cefixime can have an impact on the gut microbiome. 23 1 7

Differences

The extent of cefixime’s impact on the gut microbiome varies depending on the study. 23 1 Additionally, the effectiveness of cefixime against different bacteria can also vary between studies. 9 21

Consistency and Contradictions of Results

While cefixime has been shown to be effective in treating bacterial infections, its effectiveness may vary depending on the type of infection and the specific bacterial strain involved. 9 21 Similarly, cefixime’s impact on the gut microbiome can differ between studies. 23 1 7

Considerations for Real-World Application

Cefixime is an effective medication for bacterial infections, but it comes with risks like disrupting the gut microbiome and potentially contributing to antibiotic resistance. 23 15 It's crucial to be aware of these risks and follow your doctor’s instructions when taking cefixime. 23 15 In cases where the gut microbiome is disrupted by cefixime, considering probiotics or other measures to restore gut health might be necessary. 23

Limitations of Current Research

Many studies on cefixime are based on animal experiments and in vitro studies. Further research is needed to assess the effects and safety of cefixime in humans. 23 7 Additionally, the impact of cefixime on the gut microbiome can vary significantly between individuals, requiring further investigation. 23

Future Research Directions

More research is needed to understand the effects and safety of cefixime in humans, its impact on the gut microbiome, and its potential contribution to antibiotic resistance. 23 7 15

Conclusion

Cefixime is an effective treatment for bacterial infections, but it carries risks such as disrupting the gut microbiome and potentially contributing to antibiotic resistance. 23 15 It's essential to be aware of these risks and follow your doctor's guidance when taking cefixime. 23 15

Keywords

Benefit Keywords

Risk Keywords

Literature analysis of 24 papers

Positive Content

Neutral Content

Negative Content

Article Type

Randomized Controlled Trial1

Meta-Analysis1

Systematic Review1

Review1

Journal Article24

Betalactam therapy and intestinal flora.

Author: NovelliA, MazzeiT, FallaniS, DeiR, CassettaM I, ContiS

Bronchitis treatment

Cefetamet-pivoxil (CET) had a minimal impact on normal human intestinal flora compared to cefixime (CFX) and cefuroxime axetil (CA), which significantly affected Enterobacteriaceae and clostridia. CFX and CA also led to an increase in enterococci and the appearance of Salmonella spp. and Clostridium difficile in some cases.

Language : English

Effects of the Cistanche tubulosa Aqueous Extract on the Gut Microbiota of Mice with Intestinal Disorders.

Author: BaoXiaowei, BaiDongwen, LiuXiaolu, WangYing, ZengLanjun, WeiChenye, JinWeiquan

Gut microbiome modulation

The aqueous extract from *Cistanche tubulosa* (CT) has been shown to modulate the gut microbiome in mice with intestinal disorders. CT extract treatment rescued damaged intestinal morphology caused by cefixime. CT extract also restored the disrupted microbiome community, increased the growth of lactic acid bacteria, and moderated metabolic pathway changes induced by cefixime. These findings suggest that CT extract has beneficial effects on the gut microbiota.

Language : English

Evaluation of Clinical Properties and Diagnostic Test Results of Cephalosporin Allergy in Children.

Author: Yilmaz TopalOzge, Kulhas CelikIlknur, Turgay YagmurIrem, ToyranMuge, CivelekErsoy, KaraatmacaBetul, Dibek MisirliogluEmine

Cephalosporin allergy

This study evaluated the clinical features and diagnostic test results of pediatric patients with suspected cephalosporin allergy.

Language : English

Formulation development, evaluation and comparative study of effects of super disintegrants in cefixime oral disintegrating tablets.

Author: RemyaKs, BeenaP, BijeshPv, SheebaA

Cefixime tablet improvement

This study compared the effects of two superdisintegrants, sodium starch glycolate and crosscarmellose sodium, in Cefixime 50 mg oral disintegrating tablets. Tablets formulated with crosscarmellose sodium showed superior properties in terms of hardness, thickness, friability, weight variation, disintegration time, and dissolution rate.

Language : English

Effectiveness of Cefixime for the Treatment of Neisseria gonorrhoeae Infection at 3 Anatomic Sites: A Systematic Review and Meta-Analysis.

Author: YangKevin J, KojimaNoah, BristowClaire C, KlausnerJeffrey D

Treatment success

This study assessed the effectiveness of cefixime in treating Neisseria gonorrhoeae infection at different anatomic sites. A meta-analysis of 20 studies found that cefixime was highly effective in treating urogenital infections but less effective in treating pharyngeal infections. The study recommends further research into cefixime's effectiveness in treating rectal infections and exploring multidose therapy for pharyngeal infections.

Language : English

Photocatalytic degradation of cefixime using visible light-driven Z-scheme ZnO nanorod/Zn2TiO4/GO heterostructure.

Author: BehinehElham Sadat, Solaimany NazarAli Reza, FarhadianMehrdad, MoghadamMajid

CEF degradation

TOC removal

This study investigates the use of ZnO nanorods and Zn2TiO4/GO heterostructures for the photocatalytic degradation of Cefixime (CEF) under visible light. The optimal ternary composite, consisting of 65 wt% ZnO and 3 wt% graphene oxide, demonstrated the highest CEF degradation rate. The enhanced photocatalytic activity is attributed to the reduced electron-hole pair recombination rate, efficient interfacial charge transfer, and improved visible light absorption in the Z-scheme system. The study identified optimal operating parameters for CEF removal, including photocatalyst dosage, pH, radiation time, and CEF concentration. The photocatalytic degradation of CEF followed first-order kinetics, and the ternary composite achieved a degradation rate 2.7 and 6.2 times higher than ZnO nanorod/Zn2TiO4 and ZnO, respectively.

Language : English

Restoration of cefixime-induced gut microbiota changes by a prebiotic blend in a mouse model.

Author: YuanJingyi, QinSong, HuShanliang, LiuZhengyi, SongYipeng, LiLili

Gut health improvement

Obesity treatment

Prebiotic blends (PB) have been shown to positively impact gut microbiota, host diet, and host physiology. In a study involving C57BL/6 J mice administered cefixime, PB supplementation significantly increased the abundance of beneficial gut bacteria, such as Bifidobacterium, Parabacteroides, Alloprevotella, Alistipes, and Dubosiella. Additionally, PB supplementation significantly decreased the abundance of harmful gut bacteria, such as Robinsoniella, Blautia, Lachnoclostridium, Coprobacillus, Hungatella, Erysipelatoclostridium, Helicobacter, Clostridium sensu stricto 1, Enterococcus, and Akkermansia. PB supplementation regulated levels of microbial metabolites like unsaturated fatty acids and bile acids. These results suggest PB can help alleviate metabolic disorders caused by antibiotic intervention, making it a potential dietary strategy for those experiencing antibiotic-associated diarrhea.

Language : English

Central metabolism is a key player in E. coli biofilm stimulation by sub-MIC antibiotics.

Author: YaegerLuke N, FrenchShawn, BrownEric D, CôtéJean Philippe, BurrowsLori L

Biofilm inhibition

Antibiotic resistance

Sub-inhibitory concentrations of antibiotics can stimulate biofilm formation in Escherichia coli. This study identified genes involved in this process, highlighting the role of central metabolism and aerobic respiration in biofilm stimulation. The study also demonstrated that nitrate respiration can suppress biofilm formation, suggesting a potential strategy for combating antibiotic resistance.

Language : English

Cefixime shows good effects on group A and group B beta-haemolytic streptococci.

Author: LibertoM C, CarboneM, FeraM T, BerlinghieriM C, PuccioR, FocàA, De LucaM, CasiniA

Bactericidal effect

Effective against Group A streptococci

Cefixime, a new orally active cephalosporin, has a broad spectrum of antibacterial activity against a variety of bacteria, including Enterobacteriaceae, Haemophilus influenzae, Branhamella catarrhalis, Streptococcus pneumoniae, and Streptococcus pyogenes. This study investigated the effects of cefixime on Group A and Group B beta-haemolytic streptococci. The results show that cefixime significantly reduced the adherence of Group A streptococci to buccal cells, and 86.1% of strains showed an MIC less than or equal to 0.5 microgram/ml. Growth curves demonstrated a bactericidal effect after 3 hours. 70.3% of Group B streptococci strains exhibited an MIC less than or equal to 2 micrograms/ml. Cefixime shows good activity against beta-haemolytic streptococci, particularly Group A.

Language : English

10.

Incidence, clinical evaluation and antimicrobial susceptibility pattern of bacteria isolated from diabetic patients.

Author: MahomoodJaved, ParveenShama, AhmedNisar, ShamimSaba, MalikArif, NaqviSyed Zeeshan Haider

Treat bacterial infections

Diabetes mellitus is a metabolic disorder with rising prevalence worldwide. This study assessed the incidence, clinical profile, and bacterial resistance patterns in diabetic patients. The study found that microbial infections were common among diabetic patients, with significant resistance to antibiotics observed for certain bacteria like Staphylococcus aureus and Pseudomonas.

Language : English

11.

Evaluation of the Active Ingredient of Campsis radicans Essential Oils and its Antimicrobial Evaluation Against Pathogenic Bacteria.

Author: RamtinMaryam, SharifniyaFariba, LarypoorMohaddeseh, MirpourMirsasan, ZarrabiSaeid

Antimicrobial effect

Encapsulation efficacy

Targeted effect

This study investigated the antimicrobial effects of bark essential oils of Campsis radicans, a native plant of Northern Iran, on resistant nosocomial pathogens. The study found that both free and encapsulated forms of Guaiacol, the active ingredient in the essential oils, had antimicrobial effects on resistant strains of Pseudomonas aeruginosa, Escherichia coli, and Candida albicans. The encapsulated form showed a more significant antimicrobial effect due to its enhanced stability and targeted delivery.

Language : English

12.

In vitro antimicrobial and cytotoxic manifestations of Dicliptera roxburghiana.

Author: AhmadBushra, KhanMuhammad Rashid, ShahNaseer Ali, KhanRahmat Ali

Antimicrobial activity

This study investigated the antimicrobial and cytotoxic potential of methanol extract and its derived fractions from Dicliptera roxburghiana. The extract and its fractions showed significant antibacterial and antifungal activities against various bacterial and fungal strains. The study suggests that Dicliptera roxburghiana could be a source of natural antimicrobial compounds for the treatment of infectious diseases.

Language : English

13.

Molecular docking, molecular dynamics simulations and in vitro screening reveal cefixime and ceftriaxone as GSK3β covalent inhibitors.

Author: NassarHusam, SipplWolfgang, DahabRana Abu, TahaMutasem

Alzheimer's treatment

Cancer treatment

This study investigates the inhibitory effects of four cephalosporin antibiotics on GSK3β, a serine/threonine kinase that is a potential drug target for several diseases. Cefixime and ceftriaxone exhibited the best inhibitory activities, suggesting their potential therapeutic benefits in cancer and Alzheimer's disease.

Language : English

14.

Antibiotic-Dispensing Patterns and Awareness of Anti-microbial Resistance Among the Community Pharmacists in South-Central India.

Author: DharanindraMoturu, Shriram DhanasekaranKrishna, RayanaSupriya, NoorShaik Mohammad, BandelaPiyush, ViswanadhRudrapaka Pavan Sri, Hemanth KumarKalva

AMR exacerbation

This study assessed antibiotic dispensing patterns and awareness of antimicrobial resistance (AMR) among pharmacists in South-Central India, finding alarming rates of over-the-counter antibiotic dispensing and low AMR awareness.

Language : English

15.

Detection of multidrug resistant environmental isolates of acinetobacter and Stenotrophomonas maltophilia: a possible threat for community acquired infections?

Author: GovenderReshme, AmoahIsaac D, KumariSheena, BuxFaizal, StenströmThor A

Community-acquired infections

This study investigated the antibiotic resistance patterns, antibiotic resistance genes, efflux pumps, and virulence signatures of Acinetobacter spp. and Stenotrophomonas maltophilia isolated from river water, plant rhizosphere, and river sediment. The presence of multidrug-resistant bacteria in surface water raises concerns for community-acquired infections.

Language : English

16.

Repurposing the tyrosine kinase inhibitor nilotinib for use against intracellular multidrug-resistant Salmonella Typhimurium.

Author: ChouShih-Hsiu, WanTsai-Wen, ShiauChung-Wai, ChenLing-Han, LinHsueh-Chun, ChiuHao-Chieh

Antibacterial activity

Multidrug-resistant Salmonella enterica infections are a growing public health threat. This study found that the drug nilotinib has antibacterial activity against intracellular Salmonella in macrophages, suggesting a potential new treatment for these infections.

Language : English

17.

Hemophagocytic lymphohistiocytosis diagnosed by bone marrow trephine biopsy in living post-COVID-19 patients: case report and mini-review.

Author: IoannouMaria, ZacharouliKonstantina, DoukasSotirios G, DiamantidisMichael D, TsangariVaya, KarakousisKonstantinos, KoukoulisGeorge K, VageliDimitra P

sHLH diagnosis

Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal inflammatory syndrome. There is evidence that it can be triggered by SARS-CoV-2 infection. A recent case report showed that a living patient who recovered from COVID-19 was diagnosed with sHLH using a trephine biopsy. The trephine biopsy revealed signs of histiocytosis, hemophagocytosis, and persistent leukocytosis. The diagnostic value of trephine biopsy in post-COVID-19 patients is highlighted in this case.

Language : English

18.

Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing Escherichia coli Pathotypes in North Eastern Region of India: Backyard Small Ruminants-Human-Water Interface.

Author: LalhruaipuiiKhawlhring, DuttaTapan K, RoychoudhuryParimal, ChakrabortySatyaki, SubudhiPrasant K, SamantaIndranil, BandyopadhayaySamiran, SinghSoibam B

Antimicrobial resistance

Public health concern

This study investigated the prevalence of diarrheagenic Escherichia coli (DEC) and antimicrobial resistance (AMR) in various animal and human samples. The study found high levels of resistance to multiple antibiotics, including carbapenems, in DEC isolates from humans and water. The presence of multidrug-resistant DEC in domestic animals and potable water poses a significant public health concern.

Language : English

19.

Multidrug resistance and extended-spectrum beta-lactamase producing Gram-negative bacteria from three Referral Hospitals of Amhara region, Ethiopia.

Author: MogesFeleke, GizachewMucheye, DagnewMulat, AmareAzanaw, SharewBekele, EshetieSetegn, AbebeWondwossen, MillionYihenew, FelekeTigist, TirunehMoges

Antimicrobial resistance

MDR GNB

Multidrug-resistant (MDR), extended-spectrum beta-lactamase (ESBL), and carbapenemase-producing Gram-negative bacteria (GNB) are a major public health threat worldwide, especially in developing countries. This study assessed the prevalence of these resistant GNB in patients attending hospitals in Amhara region, Ethiopia.

Language : English

20.

Resistance pattern of infected chronic wound isolates and factors associated with bacterial resistance to third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda.

Author: KhalimWangoye, MwesigyeJames, TungotyoMartin, TwinomujuniSilvano Samba

Cephalosporin resistance

The study found that 35.3% of pathogens isolated from patients with infected chronic wounds were resistant to third-generation cephalosporins. Factors associated with resistance included previous antibiotic use, diabetes, and wound site.

Language : English

21.

Surrogate testing of oral third-generation cephalosporin susceptibility to common uropathogens.

Author: WatsonJoshua R, BurchCynthia, LeberAmy L

Predicting susceptibility to oral cephalosporins

Cefazolin resistance

Cefazolin susceptibility of urine isolates predicts susceptibility to oral cephalosporins, but cefazolin-resistant isolates may be susceptible to oral third-generation cephalosporins.

Language : English

22.

Pattern of Antibiotic Use in the Perinatal Period in a Public University Hospital in Romania.

Author: HodoșanViviana, DainaCristian Marius, ZahaDana Carmen, CotrăuPetru, VladuAdriana, PantișCarmen, DorobanțuFlorica Ramona, NegrăuMarcel, MaghiarAdriana, DainaLucia Georgeta

Antibiotic resistance

This retrospective study evaluated antibiotic use among pregnant women admitted to a hospital between 2017 and 2021. The study found a decreasing trend in antibiotic consumption between 2017 and 2019, followed by an increase between 2020 and 2021. Ceftriaxone was the most prescribed antibiotic, while first- and fourth-generation cephalosporins were rarely used. The study highlights the need for healthcare experts to evaluate existing data and select appropriate antibiotics for pregnant women.

Language : English

23.

Cephalosporins-induced intestinal dysbiosis exacerbated pulmonary endothelial barrier disruption in streptococcus pneumoniae-infected mice.

Author: WangJia-Feng, ShiChang-Yi, YingHua-Zhong

Gut dysbiosis

Higher bacterial loads

Respiratory inflammation

This study investigated the effects of three cephalosporins (cefaclor, cefdinir, and cefixime) on intestinal microbiota and lung injury in Streptococcus pneumoniae (Spn)-infected mice. The study found that cephalosporin treatment disrupted intestinal microecological homeostasis and increased the risk of Spn infection, resulting in severer respiratory inflammation and higher bacterial loads in mice.

Language : English

24.

Clinical trial protocol to evaluate the efficacy of cefixime in the treatment of early syphilis.

Author: MehtaShivani N, StafylisChrysovalantis, TellalianDavid M, BurianPamela L, OkadaCliff M, MillnerCarl E, MejiaChristopher M, KlausnerJeffrey D

Syphilis treatment

This study evaluates the efficacy of oral cefixime for the treatment of early syphilis, considering the global shortage and cost increase of benzathine penicillin. The study aims to explore cefixime as a potential alternative treatment for syphilis.

Language : English

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