Usage
Cefixime + Ornidazole is a combination antibiotic used to treat a variety of bacterial and parasitic infections, including:
- Urinary tract infections
- Respiratory tract infections (e.g., bronchitis, pharyngitis, tonsillitis, otitis media)
- Gonorrhea
- Gastrointestinal infections (e.g., amebiasis, giardiasis, dysentery)
- Periodontitis and dental abscesses
- Bacterial vaginosis
- Surgical prophylaxis
Pharmacological Classification: Antibiotic (Cefixime is a third-generation cephalosporin, Ornidazole is a nitroimidazole).
Mechanism of Action: Cefixime inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). Ornidazole damages bacterial and protozoal DNA, leading to cell death.
Alternate Names
No widely recognized alternate names exist. Brand names vary depending on the manufacturer. Some popular brand names include:
- Cefolac OZ
- Ornicef
- Afime-OZ
How It Works
Pharmacodynamics: Cefixime exerts bactericidal activity by disrupting cell wall synthesis. Ornidazole is also bactericidal and parasiticidal, causing DNA damage.
Pharmacokinetics:
- Cefixime: Absorption is variable, not significantly affected by food. Excreted primarily unchanged in urine.
- Ornidazole: Well absorbed orally. Metabolized in the liver, primarily excreted in urine.
Mode of Action: Cefixime binds to PBPs, inhibiting the final step of peptidoglycan synthesis. Ornidazole forms reactive radicals that damage microbial DNA.
Dosage
Standard Dosage
Adults: 200-400 mg of Cefixime and 500-1500 mg of Ornidazole, given once or twice daily for 7-14 days. The specific dosage and duration depend on the infection being treated.
Children: 8 mg/kg/day of Cefixime, either as a single dose or divided every 12 hours. Children over 45 kg may receive adult doses. Ornidazole dosing should be adjusted according to body weight.
Special Cases: Dosage adjustments may be necessary in elderly patients and those with renal or hepatic impairment. Consultation with a nephrologist or hepatologist is recommended.
Clinical Use Cases
Specific dosage adjustments for clinical scenarios like intubation, surgery, mechanical ventilation, or ICU use should be based on the individual patient’s condition and the infecting organism.
Dosage Adjustments
Dose modification is required in patients with renal or hepatic dysfunction.
Side Effects
Common Side Effects
- Diarrhea
- Nausea
- Vomiting
- Abdominal pain
- Headache
- Dizziness
- Loss of appetite
- Flatulence
Rare but Serious Side Effects
- Severe allergic reactions (e.g., anaphylaxis, angioedema)
- Pseudomembranous colitis
- Seizures
- Hepatitis
- Jaundice
- Blood dyscrasias
Long-Term Effects
Long-term effects are rare but may include antibiotic-associated diarrhea and Clostridium difficile infection.
Contraindications
- Hypersensitivity to cephalosporins or nitroimidazoles
- First trimester of pregnancy (for Ornidazole)
- Neurological disorders (for Ornidazole)
- Blood dyscrasias (for Ornidazole)
Drug Interactions
- Anticoagulants (e.g., warfarin)
- Lithium
- Probenecid
- Alcohol
Pregnancy and Breastfeeding
Cefixime is generally considered safe during pregnancy. Ornidazole should be avoided, especially during the first trimester. Both drugs can be excreted in breast milk; caution is advised.
Drug Profile Summary
- Mechanism of Action: Cefixime inhibits cell wall synthesis; Ornidazole damages DNA.
- Side Effects: Diarrhea, nausea, vomiting, abdominal pain, headache, dizziness.
- Contraindications: Hypersensitivity, pregnancy (Ornidazole), neurological disorders (Ornidazole).
- Drug Interactions: Anticoagulants, lithium, alcohol.
- Pregnancy & Breastfeeding: Use with caution. Consult physician.
- Dosage: Varies depending on the infection and patient factors.
- Monitoring Parameters: Renal and hepatic function, complete blood count.
Popular Combinations
This combination itself is a popular combination, specifically for mixed bacterial and protozoal infections.
Precautions
Standard precautions for antibiotic use apply. Assess for allergies, renal/hepatic function, and potential drug interactions. Alcohol should be avoided while taking Ornidazole.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Cefixime + Ornidazole?
A: Dosage varies depending on the infection and patient factors (age, weight, renal function). Adult doses are generally 200-400 mg of Cefixime and 500-1500 mg of Ornidazole once or twice daily.
Q2: Can Cefixime + Ornidazole be used in children?
A: Yes, but the dosage of Cefixime should be calculated based on body weight (8 mg/kg/day). Ornidazole dosing should also be adjusted accordingly.
Q3: What are the most common side effects?
A: The most common side effects are gastrointestinal, including diarrhea, nausea, vomiting, and abdominal pain.
Q4: Are there any serious side effects I should be aware of?
A: While rare, serious side effects can include severe allergic reactions, Clostridium difficile infection, and seizures.
Q5: Can this combination be used during pregnancy or breastfeeding?
A: Cefixime is generally considered safe during pregnancy. Ornidazole should be avoided in the first trimester. Caution is advised during breastfeeding. Consult a physician.
Q6: What are the contraindications to using Cefixime + Ornidazole?
A: Contraindications include hypersensitivity to cephalosporins or nitroimidazoles, first-trimester pregnancy (Ornidazole), and neurological disorders or blood dyscrasias (Ornidazole).
Q7: Does Cefixime + Ornidazole interact with other medications?
A: Yes, it can interact with anticoagulants (e.g., warfarin), lithium, probenecid, and alcohol.
Q8: How should Cefixime + Ornidazole be administered?
A: It can be taken orally with or without food. It is generally recommended to complete the full course of treatment, even if symptoms improve.
Q9: What should I do if a dose is missed?
A: Take the missed dose as soon as remembered, unless it is close to the time for the next dose. Do not double the dose.
