Cefixime is an oral antibiotic used to treat several common bacterial infections, including urinary tract infections, strep throat, bronchitis flare-ups, ear infections, and gonorrhea. It belongs to the third-generation cephalosporin class, meaning it works against a broad range of bacteria. It kills bacteria by blocking the final step in cell wall construction, which causes the bacterial cell to break apart and die.
Approved Uses of Cefixime
Cefixime is approved to treat a specific set of bacterial infections in adults and children. The full list includes:
- Uncomplicated urinary tract infections caused by E. coli and Proteus mirabilis, two of the most common culprits behind bladder infections.
- Strep throat and tonsillitis caused by group A strep. This indication is approved for patients as young as six months old.
- Acute flare-ups of chronic bronchitis caused by Streptococcus pneumoniae or Haemophilus influenzae.
- Uncomplicated gonorrhea of the cervix or urethra.
- Middle ear infections (otitis media) in children, caused by Haemophilus influenzae, Moraxella catarrhalis, or group A strep. This indication applies to the oral suspension form rather than the tablet.
Clinical studies show high success rates across these uses. In trials of adults with urinary tract infections, 94% were cured and another 5% improved. For bronchitis flare-ups, 98% of patients were cured or improved. In children with middle ear infections, 96% had a successful outcome.
How Cefixime Is Taken
Cefixime comes as a tablet and a liquid suspension. It can be taken with or without food, either once daily or split into two doses 12 hours apart. For gonorrhea, it is given as a single one-time dose. Your prescriber will choose the schedule based on the type of infection and its severity.
Children who weigh under 45 kg or are younger than 12 typically receive the liquid suspension, with the dose calculated by body weight. Older children and adults generally take the tablet form.
Its Role in Gonorrhea Treatment
Cefixime was once a go-to treatment for gonorrhea, but its role has narrowed. The CDC now recommends an injectable antibiotic, ceftriaxone, as the only first-line treatment for uncomplicated gonorrhea. Cefixime is reserved as a backup option when an injection isn’t possible, given as a single 800 mg oral dose.
The shift happened because of rising resistance. Between 2022 and 2024, the World Health Organization reported that gonorrhea resistance to cefixime jumped from 1.7% to 11% globally, with resistant strains appearing in more countries each year. This trend is why cefixime is no longer the preferred choice for this infection, even though it remains officially approved for it.
Common Side Effects
Cefixime is generally well tolerated. The most frequently reported side effects are gastrointestinal: loose stools, diarrhea, stomach pain, and nausea. These tend to be mild and resolve after the course is finished. Diarrhea is the most common complaint, which is typical of oral cephalosporins because they temporarily disrupt the normal bacteria in your gut.
Less common reactions include headache, dizziness, and skin rash. Allergic reactions are possible, particularly in people with a known allergy to penicillin, since cephalosporins share a similar chemical structure. If you’ve had a severe allergic reaction to penicillin in the past, make sure your prescriber knows before starting cefixime.
Use During Pregnancy and Breastfeeding
Animal studies at doses up to 40 times the human dose found no evidence of harm to the fetus, and cefixime carries a Pregnancy Category B rating. That said, no well-controlled studies have been done in pregnant women, so it is typically prescribed during pregnancy only when clearly needed.
Whether cefixime passes into breast milk is unknown. Temporary interruption of breastfeeding during treatment is sometimes recommended as a precaution.
Drug Interactions to Know About
Cefixime can increase the blood-thinning effect of warfarin. If you take warfarin or a similar anticoagulant, your prescriber will likely monitor your clotting levels more closely while you’re on the antibiotic. This interaction is common across the cephalosporin class, not unique to cefixime.
Cefixime is not heavily processed through the liver enzyme systems that cause many drug interactions, so the list of interactions is relatively short compared to some other antibiotics. Still, let your prescriber know about all medications and supplements you’re taking before starting a course.
Why It Matters to Finish the Full Course
Cefixime only works against bacteria, not viruses like colds or flu. Taking it for a non-bacterial illness won’t help and contributes to resistance. When it is appropriately prescribed, finishing every dose is important even if you feel better early. Stopping short gives surviving bacteria a chance to multiply and develop resistance, which is exactly the pattern driving the global increase in resistant gonorrhea and other infections.