Triocim 200

Indications

Triocim is an oral cephalosporin antibiotic with strong bactericidal activity against a broad range of Gram-positive and Gram-negative bacteria. It is prescribed for the treatment of various acute infections caused by susceptible microorganisms, including:

• Upper Respiratory Tract Infections (URTI): Such as otitis media and other URTIs where the causative pathogen is resistant to other common antibiotics or where treatment failure poses a significant risk.
• Lower Respiratory Tract Infections: Including bronchitis.
• Urinary Tract Infections (UTI): Such as cystitis, cystourethritis, and pyelonephritis.

Triocim has proven effective against common pathogens including Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella species, Haemophilus influenzae (both beta-lactamase positive and negative), Moraxella catarrhalis (both beta-lactamase positive and negative), and Enterobacter species. It remains highly stable in the presence of beta-lactamase enzymes.

Pharmacology

Triocim (cefixime) is a third-generation, semi-synthetic cephalosporin antibiotic for oral use. It is effective against a wide range of both Gram-positive and Gram-negative bacteria. Cefixime works by disrupting bacterial cell wall synthesis and is stable against many beta-lactamase enzymes, making it effective against bacteria resistant to other cephalosporins and penicillins. It achieves adequate plasma concentrations whether taken with or without food, with approximately 40% to 50% absorption.

Dosage & Administration

Cefixime absorption is minimally affected by food. The standard treatment duration is 7 days, extendable up to 14 days if necessary.

• Adults and Children Over 10 Years: Recommended dosage is 200-400 mg daily, either as a single dose or divided into two doses, depending on infection severity.
• Elderly: Dosage is typically the same as for adults. However, renal function should be monitored, and the dose adjusted in cases of severe renal impairment.
• Children: For children, the dosage is 8 mg/kg/day, administered as a single dose or divided into two doses. Dosage guidelines based on age are:
  • 6 months to 1 year: 3.75 ml daily
  • 1-4 years: 5 ml daily
  • 5-10 years: 10 ml daily
  • For typhoid, the recommended dose is 5 mg/kg body weight twice daily for 10-14 days.
  • Children over 50 kg or older than 10 years should receive the adult dosage of 200-400 mg daily.

  Note: The safety and efficacy of Cefixime in children under 6 months have not been established.

• Renal Impairment: In patients with creatinine clearance of 20 ml/min or greater, the usual dose can be given. For those with clearance less than 20 ml/min, the dose should not exceed 200 mg once daily. Adjustments are needed for patients on chronic peritoneal dialysis or hemodialysis.

Interactions

Triocim may increase prothrombin times in some patients, particularly those on anticoagulant therapy, so caution is advised.

Contraindications

Triocim should not be used in patients with known hypersensitivity to cephalosporin antibiotics.

Side Effects

Triocim is generally well-tolerated. Most adverse effects are mild and self-limiting. Common gastrointestinal side effects include diarrhea, nausea, abdominal pain, dyspepsia, vomiting, and flatulence, with diarrhea being more frequent at higher doses. Rarely, pseudomembranous colitis has been reported. CNS effects may include headache and dizziness. Allergic reactions such as rash, itching, and urticaria can occur but usually resolve after discontinuation. Hematological effects like thrombocytopenia and leukopenia, and minor changes in liver and kidney function tests, have been observed.

Pregnancy & Lactation

There are no well-controlled studies in pregnant women. Triocim should only be used during pregnancy if clearly needed. It is unknown whether Cefixime is excreted in breast milk, so caution is recommended when administering it to nursing mothers.

Precautions & Warnings

Use Triocim with caution in patients with a history of hypersensitivity to other drugs, especially penicillins, due to potential cross-reactivity. It should also be used cautiously in patients with impaired renal function and those at risk for Clostridium difficile-associated diarrhea. Triocim should be avoided during pregnancy and lactation unless absolutely necessary.

Overdose Effects

In the event of overdose, gastric lavage may be considered; however, no specific antidote exists. Triocim is not significantly removed by hemodialysis or peritoneal dialysis. Adverse effects from high doses are similar to those at recommended doses.

Therapeutic Class

Third-generation Cephalosporins

Storage Conditions

Store below 30ºC, protected from light and moisture. Keep out of reach of children.