Cefixime
=============

**PD Dialyzability**: Likely

Pharmacokinetic Parameters [1]_ [2]_
--------------------------------------

======= ======
/////// |pk|
======= ======
|pk1|   |v1|
|pk2|   |v2|
|pk3|   |v3|
|pk4|   |v4|
|pk5|   |v5|
|pk6|   |v6|
|pk7|   |v7|
======= ====== 

CAPD Dosing: [3]_ [4]_ [5]_
----------------------------
* 200mg PO daily

CCPD Dosing:
---------------------
* One study identified. See literature summary below. [6]_ 

Indication Specific PD Dosing:
--------------------------------------
* Peritonitis treatment - 400mg PO daily [7]_ 

* Urinary Tract Infection - 400mg PO every 2 days (see literature summary below) [8]_ 

Literature Summary:
----------------------

+--------+----------+--------------+------------+-------------------+
| Title  | Patient  | Intervention | Outcome    | Note              |
+========+==========+==============+============+===================+
| |L1|   | - |L2|   | |L3|         | - |L4|     | - |L5|            |
|  [8]_  | - |L6|   |              | - |L7|     | - |L8|            |
+--------+----------+--------------+------------+-------------------+
| |L9|   | - |L10|  | |L11|        | - |L12|    | - |L13|           |
|  [6]_  | - |L14|  |              | - |L15|    |                   |
|        | - |L16|  |              |            |                   |
|        | - |L17|  |              |            |                   |
+--------+----------+--------------+------------+-------------------+

References
------------

.. [1] Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. DrugBank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(suppl_1):D668–72. 

.. [2] American Pharmacist Association. Drug information handbook: a comprehensive resource for all clinicians and healthcare professionals [Internet]. Hudson, Ohio: American Pharmacist association; 2012 [cited 2018 Jan 24]. Available from: http://online.lexi.com.login.ezproxy.library.ualberta.ca/lco/action/home?siteid=1

.. [3] Aronoff GR. Drug prescribing in renal failure: dosing guidelines for adults and children. 5th ed. Philadelphia, PA: American College of Physicians; 2007. 

.. [4] Adjusting oral antibiotics to estimated creatinine clearance [Internet]. [cited 2018 Jan 24]. Available from: http://www.vhpharmsci.com/VHFormulary/Tools/ADJUSTING%20ORAL%20ANTIBIOTICS.pdf

.. [5] Gilbert B, Robbins P, Livornese LL. Use of Antibacterial Agents in Renal Failure. Med Clin North Am. 2011;95:677–702. 

.. [6] Cirillo P, Melfitano A, Pepe V, delli Carri P, Gesualdo L. Peritonitis due to Moraxella phenylpyruvica. Perit Dial Int. 2009;29:358–359. 

.. [7] Williams JD, Coles GA. CAPD Peritonitis. Int J Antimicrob Agents. 1992;1:165–174. 

.. [8] Guay DR, Meatherall RC, Harding GK, Brown GR. Pharmacokinetics of Cefixime ( CL 284 , 635 ; FK 027 ) in Healthy Subjects and Patients with Renal Insufficiency. Antimicrob Agents Chemother. 1986;30(3):485–90. 

.. |pk| replace:: Cefixime
.. |pk1| replace:: Molecular Weight (Da)  
.. |pk2| replace:: Plasma Protein Binding (%)
.. |pk3| replace:: Volume of Distribution (L/Kg) 
.. |pk4| replace:: Hepatic Metabolism 
.. |pk5| replace:: Excreted Unchanged (%) 
.. |pk6| replace:: Half-Life; Normal Renal Function (hours)
.. |pk7| replace:: Half-Life; ESRD (hours) 
.. |v1| replace:: 453.45
.. |v2| replace:: 65
.. |v3| replace:: 0.6–1.1
.. |v4| replace:: N/A
.. |v5| replace:: 18-50
.. |v6| replace:: 3.0-4.0
.. |v7| replace:: 11.5
.. |L1| replace:: Pharmacokinetics of cefixime (CL 284,635; FK 027) in healthy subjects and patients with renal insufficiency.
.. |L2| replace:: CAPD
.. |L3| replace:: Cefixime 400mg PO Every 2 Days.
.. |L4| replace:: Cefixime concentration 24 hours post initial dose.
.. |L5| replace:: No ADR reported
.. |L6| replace:: 4 patients on CAPD diagnosed with urinary tract infection.
.. |L7| replace:: MIC’s for urinary pathogen.
.. |L8| replace:: Study suggests extension of dosing interval may be considered over dose reduction.
.. |L9| replace:: Peritonitis due to Moraxella phenylpyruvica.
.. |L10| replace:: CCPD
.. |L11| replace:: Cefixime 400mg PO daily x 7 days.
.. |L12| replace:: Complete resolution of fever and symptoms of peritonitis.
.. |L13| replace:: No ADR reported
.. |L14| replace:: 70 year old woman
.. |L15| replace:: Hemodialysis (HD) initiated.
.. |L16| replace:: Presenting with abdominal pain, vomiting, and fever.
.. |L17| replace:: Diagnosed with peritonitis due to *Morexalla phenypyruvica*.