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Peds Calc

Safety Information

Ceftibuten Contraindications & InteractionsWhen Not to Use & Important Drug Interactions

Ceftibuten is an oral third-generation cephalosporin; vet allergy history, renal status, and GI risk factors before prescribing.

Clinical Utility: 9/10
3 Clinical Sources
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Absolute contraindications include previous anaphylaxis or SCAR to ceftibuten/cephalosporins. Relative contraindications include severe penicillin allergy, advanced renal impairment, and prior antibiotic-associated colitis. Suspension contains sucrose and may be dosed on an empty stomach—counsel caregivers accordingly.

Contraindications

Absolute Contraindications (Never Use)

Known hypersensitivity to ceftibuten or other cephalosporins

Documented anaphylaxis or severe cutaneous reactions preclude further use; choose a non-beta-lactam agent.

Relative Contraindications (Use With Caution)

History of immediate (IgE-mediated) reaction to penicillins

Cross-reactivity is low but present; consider allergy evaluation or alternate therapy for severe histories.

Renal impairment (CrCl <50 mL/min/1.73 m²)

Reduce dose or extend interval; monitor creatinine and for neurotoxicity.

Gastrointestinal disease, particularly colitis

Use cautiously in patients with a history of C. difficile; counsel about new-onset diarrhea.

Clinical References

Red Book: Oral CephalosporinsAmerican Academy of Pediatrics (2024)guideline
Penicillin Allergy Practice Parameter UpdateIDSA / AAAAI (2023)guideline