Fixica-O Actions

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Consists of cefixime, ofloxacin

Actions of Cefixime (Fixica-O) in details

The action of the drug on the human body is called Pharmacodynamics in Medical terminology. To produce its effect and to change the pathological process that is happening the body and to reduce the symptom or cure the disease, the medicine has to function in a specific way. The changes it does to the body at cellular level gives the desired result of treating a disease. Drugs act by stimulating or inhibiting a receptor or an enzyme or a protein most of the times. Medications are produced in such a way that the ingredients target the specific site and bring about chemical changes in the body that can stop or reverse the chemical reaction which is causing the disease.
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Pharmacotherapeutic Group: Antimicrobial (chemotherapeutic) agents, broad and medium spectrum antibiotics.

Pharmacology: Pharmacodynamics: Cefixime (Fixica-O) is an orally-active cephalosporin antibiotic which has in vitro bactericidal activity against a wide variety of gram-positive and gram-negative organisms including Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella sp, Haemophilus influenzae (positive and negative β-lacatamases), Moxarella (Branhamella) catarrhalis (positive and negative β-lacatamases). Cefixime (Fixica-O) is stable in the presence of β-lactamase enzymes.

Most strains of enterococci (Streptococcus faecalis, group D streptococci) and staphylococci (including coagulase positive and negative strains and methicillin-resistant strains) are resistant to Cefixime (Fixica-O). In addition, most strains of Enterobacter and Pseudomonas, Bacteroides fragilis, Listeria monocytogenes and Clostridia are resistant to Cefixime (Fixica-O).

Pharmacokinetics: Cefixime (Fixica-O), given orally, is about 40-50% absorbed whether administered with or without food; however, time to maximal absorption is increased approximately 0.8 hrs when administered with food. A single Cefixime (Fixica-O) 200 mg tablet produces an average peak serum concentration (Cmax) of approximately 2 mcg/mL (range 1-4 mcg/mL); a single Cefixime (Fixica-O) 100 mg dispersible tablet produces an average Cmax of approximately 1 mcg/mL (range 0.5-2 mcg/mL). Peak serum concentrations occur between 2 and 6 hrs following oral administration of a single 200 mg tablet or a single 100 mg tablet of Cefixime (Fixica-O).

Approximately 50% of the absorbed dose is excreted unchanged in the urine in 24 hrs. In animal studies, it was noted that Cefixime (Fixica-O) is also excreted in the bile in excess of 10% of the administered dose. Serum protein-binding is concentration-independent with a bound fraction of approximately 65%.

The serum half-life (t½) of Cefixime (Fixica-O) in healthy subjects is independent of dosage form and averages from 3-4 hrs but may range up to 9 hrs in some normal volunteers. Average area under time curve (AUC) at steady state in elderly patients are approximately 40% higher than average AUC in other healthy adults.

In subjects with moderate renal impairment [creatinine clearance (CrCl) 20-40 mL/min], the average serum t½ of Cefixime (Fixica-O) is prolonged to 6.4 hrs. In severe renal impairment (CrCl 5-20 mL/min), the t½ increased to an average of 11.5 hrs. Cefixime (Fixica-O) is not cleared significantly from the blood by hemodialysis or peritoneal dialysis. However, a study indicated that with doses of 400 mg, patients undergoing hemodialysis have similar profiles as subjects with CrCl 21-60 mL/min. There is no evidence of metabolism of Cefixime (Fixica-O) in vivo.

How should I take Cefixime (Fixica-O)?

Take Cefixime (Fixica-O) only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Shake the oral liquid well before each use. Measure the medicine with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Keep using Cefixime (Fixica-O) for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of Cefixime (Fixica-O) will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Cefixime (Fixica-O). If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed Dose

If you miss a dose of Cefixime (Fixica-O), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the oral liquid either at room temperature or in the refrigerator. Throw away any unused medicine after 14 days.

Store the tablets in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Cefixime (Fixica-O) administration

Administration of drug is important to know because the drug absorption and action varies depending on the route and time of administration of the drug. A medicine is prescribed before meals or after meals or along with meals. The specific timing of the drug intake about food is to increase its absorption and thus its efficacy. Few work well when taken in empty stomach and few medications need to be taken 1 or 2 hrs after the meal. A drug can be in the form of a tablet, a capsule which is the oral route of administration and the same can be in IV form which is used in specific cases. Other forms of drug administration can be a suppository in anal route or an inhalation route.
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Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Cefixime (Fixica-O) works best if you take it with a meal or within 30 minutes of a meal.

The Cefixime (Fixica-O) chewable tablet must be chewed before you swallow it.

Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. Breaking the pill may cause too much of the drug to be released at one time.

Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using Cefixime (Fixica-O).

Take Cefixime (Fixica-O) for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Cefixime (Fixica-O) will not treat a viral infection such as the common cold or flu.

Store the tablets and capsules at room temperature away from moisture, heat, and light.

Store the oral liquid in the refrigerator. Throw away any unused medication after 14 days.

Cefixime (Fixica-O) pharmacology

Pharmacokinetics of a drug can be defined as what body does to the drug after it is taken. The therapeutic result of the medicine depends upon the Pharmacokinetics of the drug. It deals with the time taken for the drug to be absorbed, metabolized, the process and chemical reactions involved in metabolism and about the excretion of the drug. All these factors are essential to deciding on the efficacy of the drug. Based on these pharmacokinetic principles, the ingredients, the Pharmaceutical company decides dose and route of administration. The concentration of the drug at the site of action which is proportional to therapeutic result inside the body depends on various pharmacokinetic reactions that occur in the body.
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Mechanism of Action

Cefixime (Fixica-O) is a semisynthetic cephalosporin antibacterial drug.

Pharmacokinetics

Cefixime (Fixica-O) tablets and suspension, given orally, are about 40% to 50% absorbed whether administered with or without food; however, time to maximal absorption is increased approximately 0.8 hours when administered with food. A single 200 mg tablet of Cefixime (Fixica-O) produces an average peak serum concentration of approximately 2 mcg/mL (range 1 to 4 mcg/mL); a single 400 mg tablet produces an average peak concentration of approximately 3.7 mcg/mL (range 1.3 to 7.7 mcg/mL). The oral suspension produces average peak concentrations approximately 25% to 50% higher than the tablets, when tested in normal adult volunteers. Two hundred and 400 mg doses of oral suspension produce average peak concentrations of 3 mcg/mL (range 1 to 4.5 mcg/mL) and 4.6 mcg/mL (range 1.9 to 7.7 mcg/mL), respectively, when tested in normal adult volunteers. The area under the time versus concentration curve (AUC) is greater by approximately 10% to 25% with the oral suspension than with the tablet after doses of 100 to 400 mg, when tested in normal adult volunteers. This increased absorption should be taken into consideration if the oral suspension is to be substituted for the tablet. Crossover studies of tablet versus suspension have not been performed in children.

The 400 mg capsule is bioequivalent to the 400 mg tablet under fasting conditions. However, food reduces the absorption following administration of the capsule by approximately 15% based on AUC and 25% based on Cmax.

Peak serum concentrations occur between 2 and 6 hours following oral administration of a single 200 mg tablet, a single 400 mg tablet or 400 mg of Cefixime (Fixica-O) suspension. Peak serum concentrations occur between 2 and 5 hours following a single administration of 200 mg of suspension. Peak serum concentrations occur between 3 and 8 hours following oral administration of a single 400 mg capsule.

Distribution

Serum protein binding is concentration independent with a bound fraction of approximately 65%. In a multiple dose study conducted with a research formulation which is less bioavailable than the tablet or suspension, there was little accumulation of drug in serum or urine after dosing for 14 days. Adequate data on CSF levels of Cefixime (Fixica-O) are not available.

Metabolism and Excretion

There is no evidence of metabolism of Cefixime (Fixica-O) in vivo. Approximately 50% of the absorbed dose is excreted unchanged in the urine in 24 hours. In animal studies, it was noted that Cefixime (Fixica-O) is also excreted in the bile in excess of 10% of the administered dose. The serum half-life of Cefixime (Fixica-O) in healthy subjects is independent of dosage form and averages 3 to 4 hours but may range up to 9 hours in some normal volunteers.

Special Populations

Geriatrics: Average AUCs at steady state in elderly patients are approximately 40% higher than average AUCs in other healthy adults. Differences in the pharmacokinetic parameters between 12 young and 12 elderly subjects who received 400 mg of Cefixime (Fixica-O) once daily for 5 days are summarized as follows:

Pharmacokinetic Parameters (mean ± SD) for Cefixime (Fixica-O) in Both Young & Elderly Subjects

Pharmacokinetic parameter

Young

Elderly

Cmax (mg/L)

4.74 ± 1.43

5.68 ± 1.83

Tmax (h)*

3.9 ± 0.3

4.3 ± 0.6

AUC (mg.h/L)*

34.9 ± 12.2

49.5 ± 19.1

T½ (h)*

3.5 ± 0.6

4.2 ± 0.4

Cave (mg/L)*

1.42 ±0.50

1.99 ± 0.75

*Difference between age groups was significant. (p<0.05)

However, these increases were not clinically significant.

Renal Impairment: In subjects with moderate impairment of renal function (20 to 40 mL/min creatinine clearance), the average serum half-life of Cefixime (Fixica-O) is prolonged to 6.4 hours. In severe renal impairment (5 to 20 mL/min creatinine clearance), the half-life increased to an average of 11.5 hours. The drug is not cleared significantly from the blood by hemodialysis or peritoneal dialysis. However, a study indicated that with doses of 400 mg, patients undergoing hemodialysis have similar blood profiles as subjects with creatinine clearances of 21 to 60 mL/min.

Microbiology

Mechanism of Action

As with other cephalosporins, the bactericidal action of Cefixime (Fixica-O) results from inhibition of cell wall synthesis. Cefixime (Fixica-O) is stable in the presence of certain beta-lactamase enzymes. As a result, certain organisms resistant to penicillins and some cephalosporins due to the presence of beta-lactamases may be susceptible to Cefixime (Fixica-O).

Resistance

Resistance to Cefixime (Fixica-O) in isolates of Haemophilus influenzae and Neisseria gonorrhoeae is most often associated with alterations in penicillin-binding proteins (PBPs). Cefixime (Fixica-O) may have limited activity against Enterobacteriaceae producing extended spectrum beta-lactamases (ESBLs). Pseudomonas species, Enterococcus species, strains of Group D streptococci, Listeria monocytogenes, most strains of staphylococci (including methicillin-resistant strains), most strains of Enterobacter species, most strains of Bacteroides fragilis, and most strains of Clostridium species are resistant to Cefixime (Fixica-O).

Antimicrobial Activity

Cefixime (Fixica-O) has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections [see Indications And Usage (1).

Gram-positive Bacteria

Streptococcus pneumoniae

Streptococcus pyogenes

Gram-negative Bacteria

Escherichia coli

Haemophilus influenzae

Moraxella catarrhalis

Neisseria gonorrhoeae

Proteus mirabilis

The following in vitro data are available, but their clinical significance is unknown. At least 90 percent of the following bacteria exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for Cefixime (Fixica-O) against isolates of similar genus or organism group. However, the efficacy of Cefixime (Fixica-O) in treating clinical infections caused by to these bacteria has not been established in adequate and well-controlled clinical trials.

Gram-positive Bacteria

Streptococcus agalactiae

Gram-negative Bacteria

Citrobacter amalonaticus

Citrobacter diversus

Haemophilus parainfluenzae

Klebsiella oxytoca

Klebsiella pneumoniae

Pasteurella multocida

Proteus vulgaris

Providencia species

Salmonella species

Serratia marcescens

Shigella species

Susceptibility Testing

For specific information regarding susceptibility test interpretive criteria and associated test methods and quality control standards recognized by FDA for this drug, please see: https://www.fda.gov/STIC.

Actions of Ofloxacin (Fixica-O) in details

The action of the drug on the human body is called Pharmacodynamics in Medical terminology. To produce its effect and to change the pathological process that is happening the body and to reduce the symptom or cure the disease, the medicine has to function in a specific way. The changes it does to the body at cellular level gives the desired result of treating a disease. Drugs act by stimulating or inhibiting a receptor or an enzyme or a protein most of the times. Medications are produced in such a way that the ingredients target the specific site and bring about chemical changes in the body that can stop or reverse the chemical reaction which is causing the disease.
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Pharmacokinetics: Drug concentrations in serum (in subjects with tympanostomy tubes and perforated tympanic membranes), in otorrhea and in mucosa of the middle ear (in subjects with perforated tympanic membranes) were determined following otic administration of Ofloxacin (Fixica-O) solution. In two single-dose studies, mean Ofloxacin (Fixica-O) serum concentrations were low in adult patients with tympanostomy tubes, with and without otorrhea, after otic administration of 0.3% solution [4.1 ng/mL (n=3) and 5.4 ng/mL (n=5), respectively]. In adults with perforated tympanic membranes, the maximum serum drug level of Ofloxacin (Fixica-O) detected was 10 ng/mL after administration of a 0.3% solution. Ofloxacin (Fixica-O) was detectable in the middle ear mucosa of some adult subjects with perforated tympanic membranes (11 out of 15 subjects). The variability of Ofloxacin (Fixica-O) concentration in the middle ear mucosa was high. The concentrations ranged from 1.2-602 mcg/g after otic administration of a 0.3% solution. Ofloxacin (Fixica-O) was present in high concentrations in otorrhea (389-2850 mcg/g, n=13) 30 min after otic administration of a 0.3% solution in subjects with chronic suppurative otitis media and perforated tympanic membranes. However, the measurement of Ofloxacin (Fixica-O) in the otorrhea does not necessarily reflect the exposure of the middle ear to Ofloxacin (Fixica-O).

Microbiology: Ofloxacin (Fixica-O) has in vitro activity against a wide range of gram-negative and gram-positive microorganisms. Ofloxacin (Fixica-O) exerts its antibacterial activity by inhibiting DNA gyrase, a bacterial topoisomerase. DNA gyrase is an essential enzyme which controls DNA topology and assists in DNA replication, repair, deactivation and transcription. Cross-resistance has been observed between Ofloxacin (Fixica-O) and other fluoroquinolones. There is generally no cross-resistance between Ofloxacin (Fixica-O) and other classes of antibacterial agents eg, β-lactams or aminoglycosides.

Ofloxacin (Fixica-O) has been shown to be active against most strains of the following microorganisms, both in vitro and clinically in otic infections :

Gram-Positive Aerobes: Staphylococcus aureus and Streptococcus pneumoniae.

Gram-Negative Aerobes: Haemophilus influenzae, Proteus mirabilis, Moraxella catarrhalis and Pseudomonas aeruginosa.

How should I take Ofloxacin (Fixica-O)?

Take Ofloxacin (Fixica-O) only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Ofloxacin (Fixica-O) comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

You may take Ofloxacin (Fixica-O) with or without food.

Drink plenty of fluids while you are being treated with Ofloxacin (Fixica-O). Drinking extra water will help to prevent some unwanted effects of Ofloxacin (Fixica-O).

If you are also using antacids containing aluminum or magnesium (such as Maalox®, Mylanta®), multivitamins (with calcium, iron, or zinc), didanosine (Videx®), or sucralfate (Carafate®), take these medicines at least 2 hours before or 2 hours after you take Ofloxacin (Fixica-O). These medicines may keep Ofloxacin (Fixica-O) from working properly.

Keep using Ofloxacin (Fixica-O) for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of Ofloxacin (Fixica-O) will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Ofloxacin (Fixica-O). If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed Dose

If you miss a dose of Ofloxacin (Fixica-O), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Ofloxacin (Fixica-O) administration

Administration of drug is important to know because the drug absorption and action varies depending on the route and time of administration of the drug. A medicine is prescribed before meals or after meals or along with meals. The specific timing of the drug intake about food is to increase its absorption and thus its efficacy. Few work well when taken in empty stomach and few medications need to be taken 1 or 2 hrs after the meal. A drug can be in the form of a tablet, a capsule which is the oral route of administration and the same can be in IV form which is used in specific cases. Other forms of drug administration can be a suppository in anal route or an inhalation route.

Use Ofloxacin (Fixica-O) otic exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Do not use this medication in the eyes or take it by mouth. Ofloxacin (Fixica-O) otic is intended for use in the ears only.

In general, Ofloxacin (Fixica-O) otic should be used as follows:

Ofloxacin (Fixica-O) ear drops are usually used twice a day, about 12 hours apart. Follow your doctor's instructions.

Use all of the medication that has been prescribed. Symptoms may begin to improve before the condition is completely treated. If you do not use all of the medication prescribed, the condition could return or worsen.

It is important to use Ofloxacin (Fixica-O) otic regularly to get the most benefit.

Notify your doctor if the condition does not improve or appears to worsen.

Avoid getting water inside of the affected ear(s) during treatment with Ofloxacin (Fixica-O). Care should be used while bathing, and swimming may not be recommended. Talk to your healthcare provider.

Store Ofloxacin (Fixica-O) otic at room temperature, away from moisture, heat, and direct light. Keep the bottle properly capped.

Ofloxacin (Fixica-O) pharmacology

Pharmacokinetics of a drug can be defined as what body does to the drug after it is taken. The therapeutic result of the medicine depends upon the Pharmacokinetics of the drug. It deals with the time taken for the drug to be absorbed, metabolized, the process and chemical reactions involved in metabolism and about the excretion of the drug. All these factors are essential to deciding on the efficacy of the drug. Based on these pharmacokinetic principles, the ingredients, the Pharmaceutical company decides dose and route of administration. The concentration of the drug at the site of action which is proportional to therapeutic result inside the body depends on various pharmacokinetic reactions that occur in the body.

Pharmacokinetics:

Serum, urine and tear concentrations of Ofloxacin (Fixica-O) were measured in 30 healthy women at various time points during a ten-day course of treatment with Ofloxacin (Fixica-O) Ophthalmic Solution. The mean serum Ofloxacin (Fixica-O) concentration ranged from 0.4 ng/mL to 1.9 ng/mL. Maximum Ofloxacin (Fixica-O) concentration increased from 1.1 ng/mL on day one to 1.9 ng/mL on day 11 after QID dosing for 10 1/2 days. Maximum serum Ofloxacin (Fixica-O) concentrations after ten days of topical ophthalmic dosing were more than 1000 times lower than those reported after standard oral doses of Ofloxacin (Fixica-O).

Tear Ofloxacin (Fixica-O) concentrations ranged from 5.7 to 31 mcg/g during the 40 minute period following the last dose on day 11. Mean tear concentration measured four hours after topical ophthalmic dosing was 9.2 mcg/g.

Corneal tissue concentrations of 4.4 mcg/mL were observed four hours after beginning topical ocular application of two drops of Ofloxacin (Fixica-O) Ophthalmic Solution every 30 minutes. Ofloxacin (Fixica-O) was excreted in the urine primarily unmodified.

Microbiology:

Ofloxacin (Fixica-O) has in vitro activity against a broad range of gram-positive and gram-negative aerobic and anaerobic bacteria. Ofloxacin (Fixica-O) is bactericidal at concentrations equal to or slightly greater than inhibitory concentrations. Ofloxacin (Fixica-O) is thought to exert a bactericidal effect on susceptible bacterial cells by inhibiting DNA gyrase, an essential bacterial enzyme which is a critical catalyst in the duplication, transcription, and repair of bacterial DNA.

Cross-resistance has been observed between Ofloxacin (Fixica-O) and other fluoroquinolones. There is generally no cross-resistance between Ofloxacin (Fixica-O) and other classes of antibacterial agents such as beta-lactams or aminoglycosides.

Ofloxacin (Fixica-O) has been shown to be active against most strains of the following organisms both in vitro and clinically, in conjunctival and/or corneal ulcer infections as described in the section.

*Efficasy for this organism was studied in fewer than 10 infection

The safety and effectiveness of Ofloxacin (Fixica-O) Ophthalmic Solution in treating ophthalmologic infections due to the following organisms have not been established in adequate and well-controlled clinical trials. Ofloxacin (Fixica-O) Ophthalmic Solution has been shown to be active in vitro against most strains of these organisms but the clinical significance in ophthalmologic infections is unknown.

Clinical Studies:

Conjunctivitis: In a randomized, double-masked, multicenter clinical trial, Ofloxacin (Fixica-O) Ophthalmic Solution was superior to its vehicle after 2 days of treatment in patients with conjunctivitis and positive conjunctival cultures. Clinical outcomes for the trial demonstrated a clinical improvement rate of 86% (54/63) for the Ofloxacin (Fixica-O) treated group versus 72% (48/67) for the placebo treated group after 2 days of therapy. Microbiological outcomes for the same clinical trial demonstrated an eradication rate for causative pathogens of 65% (41/63) for the Ofloxacin (Fixica-O) treated group versus 25% (17/67) for the vehicle treated group after 2 days of therapy. Please note that microbiologic eradication does not always correlate with clinical outcome in anti-infective trials.

Corneal Ulcers: In a randomized, double-masked, multi-center clinical trial of 140 subjects with positive cultures, Ofloxacin (Fixica-O) Ophthalmic Solution treated subjects had an overall clinical success rate (complete reepithelialization and no progression of the infiltrate for two consecutive visits) of 82% (61/74) compared to 80% (53/66) for the fortified antibiotic group, consisting of 1.5% tobramycin and 10% cefazolin solutions. The median time to clinical success was 11 days for the Ofloxacin (Fixica-O) treated group and 10 days for the fortified treatment group.



References

  1. DailyMed. "OFLOXACIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "CEFIXIME: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. NCIt. "Cefixime: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).

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