Community-acquired acute lower
respiratory tract infections are a common cause of illness, accounting for millions of physician visits and prescriptions each year.
Cefixime is an extended-spectrum oral
cephalosporin with activity against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, the most commonly isolated bacterial pathogens. This review presents the results of eight US studies comparing the efficacy and safety of
cefixime with those of
amoxicillin,
amoxicillin/
clavulanate,
cefaclor,
cephalexin, and
cefuroxime axetil in the treatment of patients with acute lower
respiratory tract infections. Data for 211
cefixime-treated patients and a range of 19 to 49 patients in the comparator treatment groups were included in the efficacy analysis. Clinical success (cure or improvement) was observed in 94% of
cefixime-treated patients; clinical success rates in the comparator treatment groups ranged from 97% for
cefuroxime axetil and
cefaclor to 79% for
amoxicillin/
clavulanate. At the end of treatment, the overall eradication rate in the
cefixime treatment group was 92% and ranged from 76% (
cefaclor) to 98% (
cefuroxime axetil) in the comparator treatment groups. The percentage of persistent organisms was highest in the
cefaclor (24%) and
cephalexin (21%) treatment groups. With the exception of the
cephalexin group (4%), the incidence of patients who reported adverse experiences was similar across treatment groups (34% to 50%). Those involving the gastrointestinal tract were by far the most common, and most adverse experiences were rated as mild or moderate in severity.