The Use of Cefixime in the Treatment of Chronic Obstructive Pulmonary Diseases

Abstract

Cefixime is the first oral 3-rd generation cephalosporin. This antimicrobial agent has good oral bioavailability (40-50%); Cmax in blood (2.6-4.8 mg/I)is achieved in 4 hours after single oral dose, maximal tissue concentration - in 6.7 hours. Concentration in bronchial mucosa and bronchial secret is 35-40% and 10-20% of serum concentration, respectively. Cefixime has the longest half-life (3-4 h) among oral cephalosporins that allows administering it once daily. It is active against major pathogens of non-severe exacerbations of chronic obstructive pulmonary diseases – Haemophilus spp., Moraxella catarrhalis, Enterobacteriaceae and Streptococcus pneumonia. It is important to note that degree of in vitro activity of cefixime against H.influenzae is comparable with the activity of respiratory fluoroquinolones and substantially higher than those of cefuroxime and cefaclor. On cefixime therapy 3-49% of patients experience adverse reactions that are usually mild and linked to GI tract. At the same time in real practice the rate of clinically significant adverse reactions is no more than 1-2%, with duration of persistence of main symptoms less than 3-4 days. In clinical trials the efficacy of cefixime in respiratory infections was 80-85% that is similar to respiratory fluoroquinolones and amoxicillin/clavulanate.