Usage
This combination medication is prescribed for various bacterial infections, including:
- Otitis media (ear infections)
- Pharyngitis and tonsillitis (throat infections)
- Acute bacterial exacerbation of chronic bronchitis
- Uncomplicated urinary tract infections
- Uncomplicated skin and skin structure infections
- Pneumonia
Pharmacological Classification:
- Cefixime: Cephalosporin antibiotic
- Lactic acid bacillus: Probiotic
- Linezolid: Oxazolidinone antibiotic
Mechanism of Action:
This combination acts synergistically to combat bacterial infections. Cefixime disrupts bacterial cell wall synthesis, while Linezolid inhibits bacterial protein synthesis. Lactic acid bacillus helps maintain gut flora balance, mitigating antibiotic-associated diarrhea.
Alternate Names
There are no widely recognized alternate names for this specific combination. Brand names vary by region and manufacturer. Some examples include Lizobert CF, Lizokef, and Lincef.
How It Works
Pharmacodynamics:
- Cefixime: Bactericidal action by inhibiting bacterial cell wall synthesis, leading to cell lysis.
- Linezolid: Inhibits bacterial protein synthesis by binding to the 23S ribosomal RNA of the 50S subunit, preventing formation of the 70S initiation complex.
- Lactic acid bacillus: Produces lactic acid, creating an environment unfavorable to harmful bacteria, and helps restore normal gut flora.
Pharmacokinetics:
- Cefixime: Absorption can be affected by food. Primarily excreted renally.
- Linezolid: Well absorbed orally. Metabolized hepatically. Excreted renally.
- Lactic acid bacillus: Colonizes the gastrointestinal tract.
Mode of Action:
See Pharmacodynamics.
Receptor binding, enzyme inhibition, or neurotransmitter modulation:
- Cefixime: Inhibits transpeptidases involved in bacterial cell wall synthesis.
- Linezolid: Binds to the bacterial 23S ribosomal RNA.
Elimination Pathways:
- Cefixime: Primarily renal excretion.
- Linezolid: Hepatic metabolism and renal excretion.
Dosage
Standard Dosage
Adults:
Cefixime 200-400 mg once daily or 200 mg every 12 hours, Linezolid 600 mg every 12 hours, Lactic acid bacillus as directed on the product. The duration of treatment typically ranges from 5-14 days, depending on the infection.
Children:
Dosing is weight-based and should be determined by a physician. For Cefixime, the typical dose is 8mg/kg per day, administered as a single dose or divided into two doses. For Linezolid, dosing depends on the age and the type of infection (complicated vs uncomplicated).
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary based on renal function.
- Patients with Renal Impairment: Dose reduction may be required for Cefixime and Linezolid.
- Patients with Hepatic Dysfunction: Caution advised for Linezolid. Dosage adjustments may be needed.
- Patients with Comorbid Conditions: Individualized dosing based on specific conditions.
Clinical Use Cases
Dosage for specific clinical situations should be determined by the treating physician based on individual patient factors and the infection being treated.
Dosage Adjustments:
Dose adjustments are necessary for patients with renal or hepatic impairment.
Side Effects
Common Side Effects:
- Diarrhea
- Nausea
- Vomiting
- Headache
- Abdominal pain
- Rash
Rare but Serious Side Effects:
- Stevens-Johnson syndrome (Cefixime)
- Toxic epidermal necrolysis (Cefixime)
- Pseudomembranous colitis (Cefixime)
- Anaphylaxis (Cefixime)
- Blood dyscrasias (Cefixime)
- Myelosuppression (Linezolid)
- Serotonin syndrome (Linezolid)
- Peripheral neuropathy (Linezolid)
- Lactic acidosis (Linezolid)
- Seizures (Linezolid)
Long-Term Effects:
- Peripheral and optic neuropathy (Linezolid)
- Myelosuppression (Linezolid)
- Altered gut flora and increased risk of C. difficile infection (Cefixime)
Adverse Drug Reactions (ADR):
See Rare but Serious Side Effects.
Contraindications
- Hypersensitivity to any component of the formulation.
- History of colitis or severe gastrointestinal conditions.
- Linezolid is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs).
- Concomitant use of Linezolid with serotonergic drugs requires caution.
Drug Interactions
- Cefixime: Anticoagulants (e.g., warfarin), probenecid.
- Linezolid: MAOIs, SSRIs, adrenergic agents, other serotonergic drugs, dopaminergic agents.
- Alcohol should be avoided with this combination.
- Antacids containing magnesium or aluminum may decrease Cefixime absorption.
Pregnancy and Breastfeeding
The safety of this combination during pregnancy and breastfeeding has not been established. Use with caution and only if clearly needed. It is recommended to discontinue breastfeeding while taking Linezolid.
Drug Profile Summary (see above sections for details).
Popular Combinations (This refers to this triple drug combination).
Precautions (see above sections for details).
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Cefixime + Lactic acid bacillus + Linezolid?
A: See Dosage section.
Q2: What are the common side effects?
A: See Common Side Effects section.
Q3: Can this combination be used during pregnancy?
A: Use with caution during pregnancy and only if clearly needed. Consult a physician.
Q4: What are the contraindications?
A: See Contraindications section.
Q5: What are the potential drug interactions?
A: See Drug Interactions section.
Q6: What should patients avoid while taking this medication?
A: Alcohol, certain foods (aged cheese, cured meats, some tropical fruits, beer) that can interact with Linezolid, and concomitant use of contraindicated medications.
Q7: Are there any long-term effects of this combination?
A: See Long-Term Effects section.
Q8: What monitoring parameters are recommended?
A: Complete blood count (CBC) should be monitored, especially with prolonged Linezolid use, to assess for myelosuppression. Renal and hepatic function may also need to be monitored.
Q9: Can this combination be used in children?
A: Yes, but dosage adjustments are necessary. Consult a physician.
