Markham A, Brogden R N
Adis International Limited, Auckland, New Zealand.
Drugs. 1995 Jun;49(6):1007-22. doi: 10.2165/00003495-199549060-00010.
Cefixime is an orally active third generation cephalosporin with in vitro antibacterial activity against most important lower respiratory pathogens. The drug is active against Haemophilus influenzae, Moraxella catarrhalis and penicillin-susceptible Streptococcus pneumoniae but not Staphylococcus aureus. Cefixime has a long elimination half-life (3 hours compared with 0.5 hours for cefaclor and 1.5 hours for cefalexin), which allows once daily administration. Several trials have established the clinical efficacy of the drug in patients with lower respiratory tract infection (LRTI). In comparative studies cefixime had similar efficacy to amoxicillin +/- clavulanic acid, cefaclor, cefalexin, cefuroxime axetil and clarithromycin. Trials evaluating the efficacy of cefixime as the oral component of intravenous to oral switch therapy have produced promising preliminary results although further carefully designed trials are needed in this area. As with certain other drugs of its class, gastrointestinal disturbances are the most frequently reported adverse events in patients taking cefixime and cases of pseudomembranous colitis have been reported. Thus, cefixime is an effective treatment for mild to moderate LRTI and may have a role as the oral component of intravenous to oral switch therapy although further well designed studies are needed to confirm initial favourable results in this important emerging area of antibacterial therapy.
头孢克肟是一种口服有效的第三代头孢菌素，对大多数重要的下呼吸道病原体具有体外抗菌活性。该药物对流感嗜血杆菌、卡他莫拉菌和青霉素敏感的肺炎链球菌有活性，但对金黄色葡萄球菌无活性。头孢克肟的消除半衰期较长（3小时，而头孢克洛为0.5小时，头孢氨苄为1.5小时），这使得它可以每日给药一次。多项试验已证实该药物对下呼吸道感染（LRTI）患者的临床疗效。在比较研究中，头孢克肟与阿莫西林±克拉维酸、头孢克洛、头孢氨苄、头孢呋辛酯和克拉霉素的疗效相似。评估头孢克肟作为静脉给药至口服转换治疗口服成分疗效的试验已取得了有前景的初步结果，尽管该领域还需要进一步精心设计的试验。与该类的某些其他药物一样，胃肠道不适是服用头孢克肟患者中最常报告的不良事件，并且已报告了假膜性结肠炎病例。因此，头孢克肟是治疗轻度至中度LRTI的有效药物，并且可能作为静脉给药至口服转换治疗的口服成分发挥作用，尽管需要进一步精心设计的研究来证实抗菌治疗这一重要新兴领域的初步良好结果。
