Suprax (cefixime) is a third-generation cephalosporin antibiotic indicated for the treatment of susceptible bacterial infections. It exhibits broad-spectrum activity against both Gram-positive and Gram-negative pathogens, including common respiratory, urinary tract, and ENT pathogens. Its once-daily dosing and oral formulation offer convenience and adherence benefits in outpatient settings. Suprax is particularly valued for its stability against beta-lactamases, extending its utility in an era of increasing antimicrobial resistance.

Features

• Active ingredient: cefixime
• Available as 400 mg tablets and 100 mg/5 mL oral suspension
• Third-generation cephalosporin antibiotic
• Broad-spectrum activity against Gram-positive and Gram-negative bacteria
• Beta-lactamase stable formulation
• Once-daily dosing regimen

Benefits

• Effective against common community-acquired pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis
• Convenient once-daily dosing improves patient adherence to treatment regimens
• Oral formulation allows for outpatient treatment of moderate infections
• Demonstrated clinical efficacy in respiratory, urinary, and ENT infections
• Generally well-tolerated profile with established safety data
• Suitable for both adult and pediatric populations (age 6 months and older)

Common use

Suprax is commonly prescribed for the treatment of acute bacterial exacerbations of chronic bronchitis, acute bacterial otitis media, pharyngitis and tonsillitis caused by Streptococcus pyogenes, uncomplicated urinary tract infections, and uncomplicated gonorrhea. Its spectrum makes it particularly useful in community-acquired infections where broader coverage is warranted but parenteral therapy is not required. Physicians often select Suprax when first-line antibiotics are contraindicated or when local resistance patterns favor cephalosporin use.

Dosage and direction

The recommended adult dosage is 400 mg daily, administered as a single dose or in two divided doses. For otitis media, the recommended pediatric dosage is 8 mg/kg/day of the oral suspension, administered as a single daily dose or in two divided doses. For pharyngitis and tonsillitis, the duration of therapy is typically 10 days. Suprax may be taken without regard to meals, though absorption is enhanced when taken with food. Renal impairment requires dosage adjustment: for creatinine clearance between 21-60 mL/min, administer 75% of the standard dose; for clearance ≤20 mL/min, administer 50% of the standard dose.

Precautions

Patients should be advised to complete the entire course of therapy even if symptoms improve. Use with caution in patients with gastrointestinal disease, particularly colitis. May cause false-positive reactions for glucose in the urine using Benedict’s, Fehling’s, or Clinitest® reagents. As with other broad-spectrum antibiotics, Suprax may result in overgrowth of nonsusceptible organisms, including fungi. Monitor patients for signs of superinfection. Use during pregnancy only if clearly needed, and exercise caution when administering to nursing mothers as cefixime is excreted in human milk.

Contraindications

Suprax is contraindicated in patients with known hypersensitivity to cefixime, other cephalosporins, or any component of the formulation. Cross-hypersensitivity may occur in patients allergic to penicillins; approximately 10% of penicillin-allergic patients will experience allergic reactions to cephalosporins. Avoid use in patients with a history of severe immediate hypersensitivity reactions to beta-lactam antibiotics.

Possible side effect

Common adverse reactions include diarrhea (16%), loose or frequent stools (6%), nausea (7%), abdominal pain (3%), and dyspepsia (3%). Less frequent side effects include headache, dizziness, transient elevations in liver enzymes, and vaginitis. Serious but rare adverse effects include pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis, and blood dyscrasias. Most side effects are mild to moderate in severity and self-limiting.

Drug interaction

Probenecid may increase and prolong cefixime blood levels. Concurrent use with carbamazepine may increase carbamazepine levels, potentially leading to toxicity. May enhance the anticoagulant effect of warfarin; monitor prothrombin time in patients receiving both medications. Concomitant use with potent diuretics may affect renal function and alter antibiotic clearance. Use with caution when administering with other nephrotoxic medications.

Missed dose

If a dose is missed, it should be taken as soon as possible. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintaining consistent antibiotic levels is important for efficacy, so patients should be counseled on adherence strategies.

Overdose

Symptoms of overdose may include nausea, vomiting, epigastric distress, and diarrhea. Gastric lavage may be indicated if performed soon after ingestion. Cefixime is not removed in significant quantities by hemodialysis or peritoneal dialysis. Management should be supportive and symptomatic, with particular attention to electrolyte balance and renal function.

Storage

Store tablets at controlled room temperature 20°-25°C (68°-77°F). The oral suspension, once reconstituted, should be stored at room temperature or refrigerated and discarded after 14 days. Keep container tightly closed. Protect from light and moisture. Keep out of reach of children.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Suprax is a prescription medication that should be used only under the supervision of a qualified healthcare professional. The prescribing physician should be consulted for specific diagnostic and treatment recommendations. Individual patient response and appropriate therapeutic choices may vary based on specific clinical circumstances.

Reviews

Clinical studies demonstrate Suprax efficacy rates of 85-95% for approved indications. Physicians report good patient tolerance and convenience of once-daily dosing. Some reviews note higher rates of gastrointestinal side effects compared to other cephalosporins, though these are typically manageable. The drug is generally regarded as a valuable option for outpatient treatment of susceptible infections, particularly in areas with specific resistance patterns. Pediatric formulations are well-accepted by children, with the cherry flavor masking the antibiotic taste effectively.