adorable baby smiling with joy

Peds Calc

Pediatric Reference

Cefixime Side EffectsComprehensive Pediatric Safety Guide

Cefixime is typically well tolerated; gastrointestinal upset and rash are the most common adverse effects. Counsel families to complete the full course while watching for allergy signs or severe diarrhea.

4 Categories
11 Clinical Sources
Evidence-Based
Back to Cefixime Overview

Essential Information

1

Call immediately for hives, swelling of the face or throat, or trouble breathing—signs of possible anaphylaxis.

2

Monitor stool patterns. Watery diarrhea, blood in stool, or stomach cramps may indicate C. difficile colitis.

3

Maintain hydration and offer probiotics or yogurt if tolerated to reduce antibiotic-associated diarrhea.

4

Report new bruising, pallor, or fatigue that could indicate hematologic effects.

Clinical Overview

Most side effects are manageable with supportive care. Escalate quickly for allergic reactions, persistent diarrhea, or symptoms suggesting hemolytic anemia.

Side Effect Categories

4 Systems

Gastrointestinal

3 documented effects

Total Sources: 4

Diarrhea / loose stools

Incidence: Common
Onset: Usually within the first few days
mild
2 sources
Duration

Not specified

Management

Provide oral rehydration solution and bland diet; consider probiotics if approved

Monitoring Guidelines

Escalate for severe, persistent, or bloody diarrhea

2 clinical sources• PubMed • Clinical Guidelines • FDA

Abdominal pain / nausea

Incidence: Common
Onset: Early in therapy
mild
1 sources
Duration

Not specified

Management

Give doses with food if tolerated; use antiemetics only if prescribed

Monitoring Guidelines

Evaluate if pain persists beyond 48 hours or vomiting limits intake

1 clinical sources• PubMed • Clinical Guidelines • FDA

C. difficile–associated diarrhea

Incidence: Rare
Onset: During therapy or up to 2 months after
severe
1 sources
Duration

Not specified

Management

Stop cefixime and arrange urgent evaluation for stool toxin testing and targeted therapy

Monitoring Guidelines

Watch for watery diarrhea, abdominal cramping, leukocytosis, or fever

1 clinical sources• PubMed • Clinical Guidelines • FDA

Dermatologic / hypersensitivity

3 documented effects

Total Sources: 3

Maculopapular rash

Incidence: Common
Onset: Days 3–5 of therapy
mild
1 sources
Duration

Not specified

Management

Continue if mild and non-pruritic; consider antihistamines for itching after clinician review

Monitoring Guidelines

Escalate for progression to hives or involvement of mucous membranes

1 clinical sources• PubMed • Clinical Guidelines • FDA

Urticaria / angioedema

Incidence: Rare
Onset: Any time during therapy
severe
1 sources
Duration

Not specified

Management

Stop immediately, administer antihistamines or epinephrine per protocol, seek emergency care

Monitoring Guidelines

Assess for airway compromise or wheezing

1 clinical sources• PubMed • Clinical Guidelines • FDA

Stevens–Johnson syndrome / toxic epidermal necrolysis

Incidence: Very rare
Onset: Within the first week
severe
1 sources
Duration

Not specified

Management

Emergency care with supportive management in burn unit; document severe beta-lactam allergy

Monitoring Guidelines

Look for target lesions, mucosal involvement, or skin sloughing

1 clinical sources• PubMed • Clinical Guidelines • FDA

Hematologic

2 documented effects

Total Sources: 2

Transient eosinophilia

Incidence: Uncommon
Onset: Weeks into therapy
mild
1 sources
Duration

Not specified

Management

Usually self-limited; continue therapy if asymptomatic

Monitoring Guidelines

Recheck CBC if symptoms such as rash or fever appear

1 clinical sources• PubMed • Clinical Guidelines • FDA

Hemolytic anemia

Incidence: Very rare
Onset: After several days of exposure
severe
1 sources
Duration

Not specified

Management

Discontinue immediately; obtain labs (CBC, bilirubin, LDH) and provide supportive care

Monitoring Guidelines

Watch for pallor, jaundice, dark urine, fatigue

1 clinical sources• PubMed • Clinical Guidelines • FDA

Hepatic / renal

2 documented effects

Total Sources: 2

Elevated liver enzymes

Incidence: Rare
Onset: During or shortly after therapy
mild
1 sources
Duration

Not specified

Management

Monitor if symptoms occur; typically resolves when therapy stops

Monitoring Guidelines

Assess for jaundice or right upper quadrant pain

1 clinical sources• PubMed • Clinical Guidelines • FDA

Renal impairment (dose-related)

Incidence: Very rare
Onset: More likely in pre-existing renal disease
moderate
1 sources
Duration

Not specified

Management

Adjust dosing interval; monitor renal labs for prolonged courses

Monitoring Guidelines

Watch for decreased urine output or edema

1 clinical sources• PubMed • Clinical Guidelines • FDA

Parent Communication Guide

Age-Appropriate Explanations

Infants (0-12 months)

For babies taking Cefixime, watch for signs of side effects. This medication is generally well-tolerated in infants when used as directed.

Toddlers (1-3 years)

This antibiotic helps fight germs. Call us if there is a rash, swelling, or watery poop that won’t stop.

Children (4-12 years)

Tell us if your stomach hurts, if the medicine causes diarrhea, or if you notice a rash.

Adolescents (13+ years)

Take the medicine at the same time each day, finish the full prescription, and report any rash, diarrhea, or unusual tiredness.

Common Parent Concerns

Q: Loose stools

A: Mild diarrhea is expected. Keep fluids up and consider probiotic foods. Call for watery, bloody, or persistent diarrhea.

When to validate: Same-day call if stools are bloody or child appears dehydrated

Q: Skin rash

A: A mild rash can occur. Stop dosing and contact the care team for hives, swelling, or breathing issues.

When to validate: Urgent evaluation for hives, angioedema, or mucosal lesions

Q: Missed dose

A: Give the missed dose as soon as remembered unless near the next dose. Do not double up; continue the regular schedule.

When to validate: Call if multiple doses are missed or symptoms worsen

Clinical Decision Support

Severity Assessment Framework

Framework for cefixime adverse event triage

Mild
Indicators: Loose stools <3/day, Non-pruritic rash, Mild nausea
Action: Continue therapy; provide supportive care and counseling
Moderate
Indicators: Persistent diarrhea, Pruritic rash, Signs of dehydration
Action: Consider stool studies, antiemetics, or switching therapy; ensure follow-up within 24 hours
Severe
Indicators: Anaphylaxis, Bloody diarrhea, Hemolytic anemia signs
Action: Discontinue immediately, initiate emergency management, escalate care

Treatment Decision Guidelines

Immediate Discontinuation

    Consider Alternatives

      Dose Modification

        Clinical References

        Suprax (cefixime) — FDA DailyMed•U.S. National Library of Medicine (2025)Label
        Cefixime — MedlinePlus Drug Information•MedlinePlus / NIH (2025)Database
        Cefixime•StatPearls Publishing (2024)Review
        IDSA Clinical Practice Guideline for Acute Uncomplicated Cystitis and Pyelonephritis•Clinical Infectious Diseases (2011)Guideline

        Frequently Asked Questions

        Parent and clinician concerns about Cefixime