Cefixime is broad-spectrum for gram-negative pathogens; screen for cephalosporin allergy and renal reserve before use.
Absolute contraindications include prior anaphylaxis or SCAR to cefixime or related cephalosporins. Relative contraindications cover severe penicillin allergy, significant renal dysfunction, or recurrent C. difficile infection where risk-benefit must be weighed.
Documented severe hypersensitivity (anaphylaxis, angioedema, SJS/TEN) to cefixime or any cephalosporin
Known hypersensitivity to suspension excipients
History of IgE-mediated beta-lactam reaction—assess cross-reactivity risk before prescribing
Creatinine clearance <60 mL/min—extend dosing interval and monitor renal function
Prior Clostridioides difficile-associated colitis—counsel on recurrence risk and monitor stools
Prolonged therapy in renal or hepatic impairment—monitor CBC, liver enzymes, and renal function