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Ceftibuten

Ceftibuten

Pronunciation: seff-TIE-byoo-ten

Class: Antibiotic, Cephalosporin

For ProfessionalsSide EffectsInteractionsMore…

Trade Names

Cedax

– Capsules 400 mg

– Powder for oral suspension 90 mg per 5 mL

– Powder for oral suspension 180 mg per 5 mL

Pharmacology

Inhibits mucopeptide synthesis in bacterial cell wall.

Pharmacokinetics

Absorption

Capsules C max is 17.9 mcg/mL.

Suspension C max is about 15 mcg/mL. T max is about 2.6 h. AUC is about 73.7 mcg•h/mL.

Food Capsules T max is increased 1.75 h. C max is decreased 18%. AUC is decreased 8%.

Suspension C max is decreased 17% to 26%. AUC is decreased 12% to 17%. Take on an empty stomach.

Distribution

Vd is about 0.21 L/kg (capsules) and 0.5 L/kg (suspension).

Elimination

The t ½ is about 2.4 h. Cl is about 1.3 mL/min/kg. About 56% is excreted in the urine and 39% in the feces.

Special Populations

Renal Function Impairment

The t ½ is increased and Cl decreased. Dosage adjustment is recommended.

Elderly

Drug accumulation in the plasma was increased to 40%. Dosage adjustment may be needed.

Indications and Usage

Treatment of pharyngitis/tonsillitis caused by Streptococcus pyogenes , otitis media caused by Moraxella catarrhalis , Haemophilus influenzae (including betalactamase-producing strains) or S. pyogenes , and acute bacterial exacerbation of chronic bronchitis caused by Streptococcus pneumoniae (penicillin-susceptible strains), H. influenzae (including betalactamase-producing strains) or M. catarrhalis (including betalactamase-producing strains).

Contraindications

Hypersensitivity to cephalosporins.

Dosage and Administration

Adults and Children 12 yr of age and older PO 400 mg every day for 10 days.

Children younger than 12 yr of age PO 9 mg/kg every day (max 400 mg) for 10 days. Give suspension 2 h before or 1 h after a meal.

General Advice

Administer oral suspension 2 h before or 1 h after meal.

Storage/Stability

After mixing, the suspension may be kept for 14 days stored in refrigerator. Keep tightly closed. Shake well before use. Capsules may be stored at room temperature.

Drug Interactions

None well documented.

Laboratory Test Interactions

May cause false-positive urine glucose test results with Benedict solution, Fehling solution or Clinitest tablets, but not with enzyme-based tests (eg, Clinistix , Test-tape ); false-positive test results for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs test results in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values.

Adverse Reactions

GI

Nausea; vomiting; diarrhea; anorexia; abdominal pain or cramps; flatulence; colitis.

Genitourinary

Pyuria; dysuria; renal function impairment; reversible interstitial nephritis; hematuria; toxic nephropathy.

Hematologic

Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; aplastic anemia; hemorrhage.

Hepatic

Hepatic function impairment; abnormal LFT results.

Miscellaneous

Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis; serum sickness–like reactions (eg, skin rash, polyarthritis, arthralgia, fever); candidal overgrowth.

Precautions

Monitor

Response to therapy Monitor patient’s response to therapy. Notify health care provider if infection does not appear to improve or worsens.

Adverse reactions Monitor patient for GI, DERM, and general body adverse reactions, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.

Pregnancy

Category B .

Lactation

Undetermined.

Children

In infants, consider benefits relative to risks. Safety and efficacy in children younger than 6 mo of age not established.

Hypersensitivity

Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-sensitivity.

Renal Function

Use drug with caution in patients with renal function impairment. Dosage adjustment based on renal function may be required.

Superinfection

May result in bacterial or fungal overgrowth on nonsusceptible microorganisms.

Pseudomembranous colitis

Consider possibility in patients in whom diarrhea develops.

Hemodialysis patients

A single 400 mg capsule or 9 mg/kg (max, 400 mg) dose may be administered at the end of each hemodialysis session.

Overdosage

Symptoms

Seizures.

Patient Information

  • Inform diabetic patients that oral suspension contains 1 g sucrose/teaspoon of suspension.
  • Instruct patient to complete full course of therapy.
  • Have patient take drug with food or milk to avoid GI upset.
  • Notify health care provider if patient has penicillin allergy or cephalosporin allergy.
  • Notify health care provider of nausea, vomiting, or diarrhea, especially if severe or contains blood, mucus or pus.
  • Remind diabetic patient to use an enzyme-based test for urine glucose or may otherwise obtain a false-positive result.
  • Remind patient to check body temperature daily. If fever persists for more than a few days or if high fever (higher than 102°F) or shaking chills are noted, notify health care provider.
  • Instruct patient to report signs of superinfection: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
  • Instruct patient to seek emergency care if he or she experiences wheezing or difficulty breathing.

Copyright © 2009 Wolters Kluwer Health.

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Ceftibuten

Ceftibuten

Generic Name: ceftibuten (sef-TYE-byoo-ten)

Brand Name: Cedax

OverviewSide EffectsDosageInteractionsFor ProfessionalsMore…

Ceftibuten is used for:

Treating mild to moderate infections caused by certain bacteria.

Ceftibuten is a cephalosporin antibiotic. It works by killing sensitive bacteria.

Do NOT use ceftibuten if:

  • you are allergic to any ingredient in ceftibuten or any other cephalosporin antibiotic (eg, cephalexin)

Contact your doctor or health care provider right away if any of these apply to you.

Before using ceftibuten:

Some medical conditions may interact with ceftibuten. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to a penicillin (eg, amoxicillin) or other beta-lactam antibiotic (eg, imipenem)
  • if you have a blood clotting disorder, kidney problems, or stomach or bowel problems (eg, inflammation)

Some MEDICINES MAY INTERACT with ceftibuten. However, no specific interactions with ceftibuten are known at this time.

This may not be a complete list of all interactions that may occur. Ask your health care provider if ceftibuten may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use ceftibuten:

Use ceftibuten as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Ceftibuten may be taken with or without food.
  • To clear up your infection completely, continue using ceftibuten for the full course of treatment even if you feel better in a few days.
  • If you miss a dose of ceftibuten, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use ceftibuten.

Important safety information:

  • Ceftibuten is effective only against bacteria. It is not effective for treating viral infections (eg, the common cold)
  • It is important to use ceftibuten for the full course of treatment. Failure to do so may decrease the effectiveness of ceftibuten and may increase the risk that the bacteria will no longer be sensitive to ceftibuten and will not be able to be treated by this or certain other antibiotics in the future.
  • Long-term or repeated use of ceftibuten may cause a second infection. Your doctor may want to change your medicine to treat the second infection. Contact your doctor if signs of a second infection occur.
  • If severe diarrhea, stomach pain or cramps, or bloody stools occur, contact your doctor immediately. This could be a symptom of a serious side effect requiring immediate medical attention. Do not treat diarrhea without consulting your doctor.
  • Diabetes patients – Ceftibuten may cause incorrect test results with some urine glucose tests. Check with your doctor before you adjust the dose of your diabetes medicine or change your diet.
  • Ceftibuten may interfere with certain lab test results. Make sure your doctor and lab personnel know you are using ceftibuten.
  • Use ceftibuten with caution in the ELDERLY because they may be more sensitive to its effects.
  • Use ceftibuten with extreme caution in CHILDREN younger than 6 months of age. Safety and effectiveness in this age group have not been confirmed.
  • Use ceftibuten with extreme caution in CHILDREN younger than 10 years of age who have diarrhea or a stomach or bowel infection.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking ceftibuten, discuss with your doctor the benefits and risks of using ceftibuten during pregnancy. It is unknown if ceftibuten is excreted in breast milk. If you are or will be breast-feeding while you are using ceftibuten, check with your doctor of pharmacist to discuss the risk to your baby.

Possible side effects of ceftibuten:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; headache; indigestion; loose stools; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; dark urine; decreased urination; fever, chills, or sore throat; joint pain; mental or mood changes; red, swollen, or blistered skin; seizures; severe diarrhea; severe stomach pain or cramps; unusual bruising or bleeding; unusual tiredness or weakness; vaginal irritation or discharge; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include muscle spasms; seizures.

Proper storage of ceftibuten: Store ceftibuten at room temperature, between 36 and 77 degrees F (2 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep ceftibuten out of the reach of children and away from pets.

General information:

  • If you have any questions about ceftibuten, please talk with your doctor, pharmacist, or other health care provider.
  • Ceftibuten is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take ceftibuten or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about ceftibuten. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to ceftibuten. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using ceftibuten.

Issue Date: March 6, 2013 Database Edition 13.1.1.003 Copyright © 2013 Wolters Kluwer Health, Inc.

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Ceftibuten

Ceftibuten

Class: Third Generation Cephalosporins

Molecular Formula: C15H14N4O6S2

CAS Number: 97519-39-6

Brands: Cedax

For ProfessionalsSide EffectsInteractionsMore…

Introduction

Antibacterial; β-lactam antibiotic; third generation cephalosporin.1 3

Uses for Ceftibuten

Otitis Media

Treatment of acute otitis media (AOM) caused by H. influenzae (including β-lactamase-producing strains), M. catarrhalis (including β-lactamase-producing strains), or S. pyogenes (group A β-hemolytic streptococci).1 2 3 5 7 8 42 (See Acute Otitis Media under Cautions.)

Management of otitis media with effusion†.36 Use of anti-infectives controversial; they provide only limited benefit in enhancing resolution of effusion and may promote resistance.36 49 50 51 52 67 68

Pharyngitis and Tonsillitis

Treatment of pharyngitis and tonsillitis caused by S. pyogenes (group A β-hemolytic streptococci).1 2 16 Generally effective in eradicating S. pyogenes from the nasopharynx, but efficacy in prevention of subsequent rheumatic fever has not been established to date.1

CDC, AAP, IDSA, AHA, and others recommend oral penicillin V or IM penicillin G benzathine as treatments of choice;12 13 25 53 oral cephalosporins and oral macrolides considered alternatives.12 13 25 53 Amoxicillin sometimes used instead of penicillin V, especially for young children.13 53

Respiratory Tract Infections

Treatment of acute bacterial exacerbations of chronic bronchitis caused by Streptococcus pneumoniae (penicillin-susceptible strains only), Haemophilus influenzae (including β-lactamase-producing strains), or Moraxella catarrhalis (including β-lactamase-producing strains).1 2 9 26 37

Treatment of acute maxillary sinusitis† caused by susceptible S. pneumoniae, H. influenzae, or M. catarrhalis.3 45

Treatment of acute bronchitis†,3 26 27 46 bronchiectasis†,47 or pneumonia†3 46 47 caused by susceptible bacteria.

Urinary Tract Infections (UTIs)

Treatment of uncomplicated UTIs† caused by susceptible Escherichia coli, Klebsiella, Proteus mirabilis, Enterobacter, or staphylococci.3 63 64

Treatment of complicated or recurrent UTIs† caused by susceptible E. coli, Klebsiella, P. mirabilis, Enterobacter, or staphylococci.3 63 64

Ceftibuten Dosage and Administration

Administration

Oral Administration

Administer capsules orally without regard to meals.1 17

Administer oral suspension at least 2 hours before or 1 hour after meals.1 2

Reconstitution

Reconstitute oral suspension at time of dispensing by adding the amount of water specified on the container in 2 portions; invert bottle and shake after each addition.1

Dosage

Available as ceftibuten dihydrate; dosage expressed in terms of anhydrous ceftibuten.1

Pediatric Patients

Otitis Media
Acute Otitis Media (AOM)

Oral Children 6 months through 11 years of age: 9 mg/kg (up to 400 mg) once daily for 10 days.1

Children ≥12 years of age: 400 mg once daily for 10 days.1 3

Pediatric Dosage of Ceftibuten Oral Suspension for AOM1
Weight (kg)

Daily Dosage

10

90 mg once daily1

20

180 mg once daily1

40

360 mg once daily1

>45

400 mg once daily1

Otitis Media with Effusion†

Oral Children 7 months to 12 years of age: 9 mg/kg (up to 400 mg) once daily for 14 days.36

Pharyngitis and Tonsillitis
Oral

Children 6 months through 11 years of age: 9 mg/kg (up to 400 mg) once daily for 10 days.1

Children ≥12 years of age: 400 mg once daily for 10 days.1

Pediatric Dosage of Ceftibuten Oral Suspension for Pharyngitis and Tonsillitis1
Weight (kg)

Daily Dosage

10

90 mg once daily1

20

180 mg once daily1

40

360 mg once daily1

>45

400 mg once daily1

Respiratory Tract Infections
Acute Exacerbations of Chronic Bronchitis

Oral Children ≥12 years of age: 400 mg once daily for 10 days.1 3

Adults

Acute Otitis Media (AOM)
Oral

400 mg once daily for 10 days.1 3

Pharyngitis and Tonsillitis
Oral

400 mg once daily for 10 days.1 3

Respiratory Tract Infections
Acute Exacerbations of Chronic Bronchitis

Oral 400 mg once daily for 10 days.1 3

Uncomplicated UTIs
Oral

400 mg once daily for 7 days.64

Prescribing Limits

Pediatric Patients

Oral

Maximum 400 mg once daily for children 6 months through 11 years of age.1

Adults

Oral

Maximum 400 mg once daily.1

Special Populations

Hepatic Impairment

No dosage adjustments required.1

Renal Impairment

Dosage for Renal Impairment1
Clcr (mL/min)

Daily Dosage

>50

9 mg/kg or 400 mg once every 24 hours1

30–49

4.5 mg/kg or 200 mg once every 24 hours1 4

5–29

2.25 mg/kg or 100 mg once every 24 hours1 4

For patients undergoing hemodialysis 2 or 3 times weekly, a single 400-mg dose (given as a capsule) or 9 mg/kg (up to 400 mg; given as the oral suspension) may be given at the end of each dialysis period.1 5

Geriatric Patients

No dosage adjustments required other than those related to renal impairment.1 (See Renal Impairment under Dosage and Administration.)

Cautions for Ceftibuten

Contraindications

  • Known hypersensitivity to ceftibuten or other cephalosporins.1

Warnings/Precautions

Warnings

Superinfection/Clostridium difficile-associated Diarrhea and Colitis

Possible emergence and overgrowth of nonsusceptible organisms (e.g., Enterobacter, Pseudomonas, enterococci, Candida) with prolonged use.a Careful observation of the patient is essential.1 Institute appropriate therapy if superinfection occurs.1 a

Treatment with anti-infectives may permit overgrowth of Clostridium difficile.1 C. difficile-associated diarrhea and colitis (CDAD; also known as antibiotic-associated diarrhea and colitis or pseudomembranous colitis) has been reported with nearly all anti-infectives, including ceftibuten, and may range in severity from mild diarrhea to fatal colitis.1

Consider CDAD if diarrhea develops during or after therapy and manage accordingly.1 Careful medical history is necessary since CDAD has been reported to occur as late as 2 months or longer after anti-infective therapy is discontinued.

If CDAD is suspected or confirmed, the anti-infective may need to be discontinued. Some mild cases may respond to discontinuance alone.1 Manage moderate to severe cases with fluid, electrolyte, and protein supplementation, anti-infective therapy active against C. difficile (e.g., oral metronidazole or vancomycin), and surgical evaluation when clinically indicated.1

Sensitivity Reactions

Hypersensitivity Reactions

Possible hypersensitivity reactions such as urticaria, pruritus, rash (maculopapular, erythematous, morbilliform), fever and chills, eosinophilia, joint pain or inflammation, edema, erythema, genital and anal pruritus, angioedema, shock, hypotension, vasodilatation, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis, and anaphylaxis.a

If hypersensitivity reaction occurs, discontinue ceftibuten and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, maintenance of an adequate airway and oxygen).1

Cross-hypersensitivity

Partial cross-sensitivity among cephalosporins and other β-lactam antibiotics, including penicillins and cephamycins.1 43

Prior to initiation of therapy, make careful inquiry concerning previous hypersensitivity reactions to any cephalosporins or penicillins.1 Cautious use recommended in individuals hypersensitive to penicillins:a avoid use in those who have had an immediate-type (anaphylactic) hypersensitivity reaction1 43 44 and administer with caution to those who have had a delayed-type (e.g., rash, fever, eosinophilia) reaction.a

General Precautions

Diabetes Mellitus

Reconstituted oral suspension contains 1 g of sucrose per 5 mL.1

Acute Otitis Media

Possibly less effective than some other β-lactam antibiotics for the treatment of AOM caused by S. pneumoniae.1 2 7 Use for empiric therapy only when adequate antimicrobial coverage against S. pneumoniae has been previously administered.1 2

History of GI Disease

Use with caution in patients with a history of GI disease, particularly colitis.1 (See Superinfection/Clostridium difficile-associated Colitis under Cautions.)

Specific Populations

Pregnancy

Category B.1

Lactation

Not known whether distributed into milk;1 use with caution.1

Pediatric Use

Safety and efficacy not established in children <6 months of age.1

Increased incidence of diarrhea in pediatric patients ≤2 years of age compared with older pediatric patients.1

Geriatric Use

Increased peak plasma concentrations and half-life may be due to age-related changes in renal function.1 3 5 17 Adjust dosage based on the degree of renal impairment.1 (See Renal Impairment under Dosage and Administration.)

Hepatic Impairment

Pharmacokinetics not altered; dosage adjustments not required.1 3

Renal Impairment

Increased plasma half-life and decreased total body clearance.1 4

Use with caution and reduce dosage.a (See Renal Impairment under Dosage and Administration.)

Careful clinical observation and renal function tests recommended prior to and during cephalosporin therapy.a

Common Adverse Effects

GI effects (e.g., nausea, diarrhea, dyspepsia, vomiting, abdominal pain), headache, dizziness, increased BUN concentrations, eosinophilia.1 3 5 34

Interactions for Ceftibuten

Specific Drugs

Drug

Interaction

Antacids

No known pharmacokinetic interaction1

Histamine H2-receptor antagonists (ranitidine)

Potential for increased ceftibuten concentrations1

Theophylline

No evidence of pharmacokinetic interaction with IV theophylline;1 effects of concomitant oral theophylline unknown

Ceftibuten Pharmacokinetics

Absorption

Bioavailability

Rapidly and almost completely absorbed following oral administration.1 5 28 29 31 Oral bioavailability is 75–90%.5

In adults, a 400-mg ceftibuten dose given as the oral suspension is bioequivalent to a 400-mg dose given as 400-mg capsules.40

Food

Food decreases rate and extent of absorption of ceftibuten; this effect is more pronounced with the oral suspension than with capsules.1 2 31

Distribution

Extent

Distributed into blister fluid,31 bronchial secretions,1 31 33 nasal secretions,31 sputum,1 middle ear fluid,1 31 32 tracheal secretions,31 and tonsillar tissue.41

Not known whether the drug crosses the placenta or is distributed into milk.1 66

Plasma Protein Binding

Approximately 65%.1

Elimination

Metabolism

Ceftibuten is present in plasma and urine principally as cis-ceftibuten; about 10% of a dose is converted in vivo to trans-ceftibuten.1 29 The trans-isomer has only about 12% of the antibacterial activity of the cis-isomer.1 30

Elimination Route

The cis- and trans-isomers of ceftibuten eliminated principally in urine.1 29 30 Approximately 56% of a dose eliminated in urine and 39% excreted in feces within 24 hours.1

Half-life

Adults with normal renal function: 2–2.6 hours.1 29 30 31

Children 6 months to 16 years of age: 1.9–2.5 hours.31 35

Special Populations

In renal impairment, plasma half-life averages 7.1–22.3 hours depending on creatinine clearance.1

Stability

Storage

Oral

Capsules

Tight container at 2–25°C.1

For Suspension

2–25°C.1 Following reconstitution, store suspension at 2–8°C for up to 14 days.1

Actions and Spectrum

  • Third generation cephalosporin with an expanded spectrum of activity against aerobic gram-negative bacteria compared with first and second generation cephalosporins.3 5

  • Usually bactericidal.a
  • Like other β-lactam antibiotics, antibacterial activity results from inhibition of bacterial cell wall synthesis.a
  • In vitro spectrum of activity includes some gram-positive aerobic bacteria and some gram-negative aerobic bacteria; inactive against most anaerobes; inactive against fungi and viruses.3 19 a
  • Gram-positive aerobes: active in vitro and in clinical infections against Streptococcus pneumoniae (penicillin-susceptible strains only) and S. pyogenes (group A β-hemolytic streptococci).1 Inactive against other streptococci, staphylococci, and enterococci (e.g., Enterococcus faecalis).3 19 a
  • Gram-negative aerobes: active in vitro and in clinical infections against Haemophilus influenzae (including β-lactamase-producing strains) and Moraxella catarrhalis (including β-lactamase-producing strains).1 Inactive against Pseudomonas aeruginosa.1 3 5 19 22 23
  • Stable in the presence of a variety of plasmid-mediated β-lactamases produced by gram-positive and gram-negative bacteria;1 2 3 5 7 8 19 20 21 22 23 more active in vitro than other currently available oral third generation cephalosporins against Enterobacteriaceae that produce plasmid-mediated β-lactamases.3 5 7 19 20 21 22 23 Unstable in the presence of chromosomally-mediated cephalosporinases.1
  • Strains of staphylococci resistant to penicillinase-resistant penicillins (oxacillin-resistant [methicillin-resistant] staphylococci) should be considered resistant to ceftibuten, although results of in vitro susceptibility tests may indicate that the organisms are susceptible to the drug.24

Advice to Patients

  • Importance of administering oral suspension at least 2 hours before or 1 hour after meals.1 2 Capsules may be administered without regard to meals.1 17

  • Importance of completing full course of therapy.1
  • Advise patients that diarrhea is a common problem caused by anti-infectives and usually ends when the drug is discontinued. Importance of contacting a clinician if watery and bloody stools (with or without stomach cramps and fever) occur during or as late as 2 months or longer after the last dose.
  • Importance of discontinuing ceftibuten and informing clinician if an allergic reaction occurs.1
  • For patients with diabetes, importance of being informed of sucrose content of oral suspension.1
  • Importance of informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.1
  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
  • Importance of advising patients of other important precautionary information.1 (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Ceftibuten Dihydrate
Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

400 mg (of anhydrous ceftibuten)

Cedax

Shionogi

For suspension

90 mg (of anhydrous ceftibuten) per 5 mL

Cedax

Shionogi

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2013. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Cedax 400MG Capsules (PERNIX THERAPEUTICS): 20/$299.99 or 60/$859.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug’s actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2013, Selected Revisions February 1, 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Shionogi USA. Cedax (ceftibuten) capsules and oral suspension prescribing information. Florham Park, NJ; 2004 Aug.

2. Schering Corporation. Cedax profile. Kenilworth, NJ.

3. Wiseman LR, Balfour JA. Ceftibuten: a review of its antibacterial activity, pharmacokinetic properties and clinical efficacy. Drugs. 1994; 47:784-808. [PubMed 7520858]

4. Kelloway JS, Awni WM, Lin CC et al. Pharmacokinetics of ceftibuten-cis and its trans metabolite in healthy volunteers and in patients with chronic renal insufficiency. Antimicrob Agents Chemother. 1991; 35:2267-74. [IDIS 295994] [PubMed 1803999]

5. Spector S. Review of the properties and features of ceftibuten: a new orally active antibiotic. Infect Dis Clinical Pract. 1995; 4(Suppl 2): S113-23.

6. Klein JO. Selection of oral antimicrobial agents for otitis media and pharyngitis. Infect Dis Clin Pract. 1995; 4(Suppl 2):S88-94.

7. Blumer JL, McLinn SE, Deabate CA et al. Multinational multicenter controlled trial comparing ceftibuten with cefaclor for the treatment of acute otitis media. Pediatr Infect Dis J. 1995; 14(Suppl):S115-20. [IDIS 349762] [PubMed 7567311]

8. McLinn SE, McCarty JM, Perrotta R et al. Multicenter controlled trial comparing ceftibuten with amoxicillin/clavulanate in the empiric treatment of acute otitis media. Pediatr Infect Dis J. 1995; 14(Suppl):S108-14.

9. Bensch GW, Klaustermeyer WB, McCarty J et al. Efficacy and safety of once-daily ceftibuten vs. twice-daily ciprofloxacin in the treatment of acute exacerbation of chronic bronchitis. Infect Dis Clin Pract. 1995; 4(Suppl 2): S80-7.

10. Chin NX, Huang HB, Neu HC. Postantibiotic effect of ceftibuten on respiratory pathogens. Pediatr Infect Dis J. 1995; 14(Suppl):S84-7.

11. Neu HC. Ceftibuten: minimal inhibitory concentration, postantibiotic effect and beta-lactamase stability—a rationale for dosing programs. Pediatr Infect Dis J. 1995; 14:S88-92.

12. Dajani A, Taubert K, Ferrieri P et al and the American Heart Association Committee on Rheumatic Fever et al. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Pediatrics. 1995; 96:758-64. [IDIS 355409] [PubMed 7567345]

13. American Academy of Pediatrics. 2006 Red Book: Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006:755.

14. Bisno AL. Streptococcus pyogenes. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 4th ed. New York: Churchill Livingstone; 1995:1786-99.

15. Anon. Choice of antibacterial drugs. Med Lett Treat Guid. 2004; 2:15-16.

16. Pichichero ME, McLinn SE, Gocch WM III et al. Ceftibuten vs. penicillin V in group A beta-hemolytic streptococcal pharyngitis. Pediatr Infect Dis J. 1995; 14(Suppl):S102-7.

17. Schering Corporation, Kenilworth, NJ: Personal communication.

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20. Bauernfeind A. Ceftibuten and bactericidal kinetics: comparative in vitro activity against Enterobacteriaceae producing extended spectrum beta-lactamases. Diagn Microbiol Infect Dis. 1991; 14:89-92. [PubMed 2013215]

21. Bauernfeind A. Comparative antimicrobial spectrum and activity of ceftibuten against clinical isolates from West Germany. Diagn Microbiol Infect Dis. 1991; 14:63-74. [PubMed 2013211]

22. Jones RN. Ceftibuten: a review of antimicrobial activity, spectrum and other microbiologic features. Pediatr Infect Dis J. 1995; 14:S77-83. [IDIS 349756] [PubMed 7567314]

23. Jones RN, Barry AL. Antimicrobial activity, spectrum, and recommendations for disk diffusion susceptibility testing of ceftibuten (7432-S; SCH 39720), a new orally administered cephalosporin. Antimicrob Agents Chemother. 1988; 32:1576-82. [IDIS 246913] [PubMed 3190185]

24. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; sixteenth informational supplement. CLSI document M100-S16. Wayne, PA; 2006.

25. Cooper RJ, Hoffman JR, Bartlett JG et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med. 2001; 134:509-17. [IDIS 460578] [PubMed 11255530]

26. Perotta R, McCabe R, Rumans L et al. Comparison of the efficacy and safety of ceftibuten and cefaclor in the treatment of acute bacterial bronchitis. Infect Dis Clin Pract. 1994; 3:270-6.

27. Chirurgi VA, Edelstein H, Oster SE et al. Ceftibuten versus cefaclor for the treatment of bronchitis. J Antimicrob Chemother. 1991; 28:577-80. [PubMed 1761452]

28. Bressolle F, Galtier M, Kinowski JM et al. Multiple-dose pharmacokinetics of ceftibuten after oral administration to healthy volunteers. J Pharm Sci. 1994; 83:1236-40. [IDIS 334891] [PubMed 7830237]

29. Lin C, Lim J, Radwanski E et al. Pharmacokinetics and dose proportionality of ceftibuten in men. Antimicrob Agents Chemother. 1995; 39:359-61. [IDIS 341970] [PubMed 7726498]

30. Lin C, Radwanski E, Affrime M et al. Multiple-dose pharmacokinetics of ceftibuten in healthy volunteers. Antimicrob Agents Chemother. 1995; 39:356-8. [IDIS 341969] [PubMed 7726497]

31. Barr WH, Affrime M, Lin CC et al. Pharmacokinetics of ceftibuten in children. Pediatr Infect Dis J. 1995; 14(Suppl):S93-101. [IDIS 349759] [PubMed 7567317]

32. Lin C, Kumari P, Perrotta RJ et al. Penetration of ceftibuten into middle ear fluid. Antimicrob Agents Chemother. 1996; 40:1394-6. [IDIS 368420] [PubMed 8726007]

33. Scaglione F, Triscari F, Demartini G et al. Concentrations of ceftibuten in bronchial secretions. Chemotherapy. 1995; 41:229-33. [IDIS 352360] [PubMed 7555201]

34. Reidenberg BE. Worldwide safety experience with ceftibuten pediatric suspension. Pediatr Infect Dis J. 1995; 14(Suppl):S130-3.

35. Kearns GL, Reed MD, Jacobs RF et al. Single-dose pharmacokinetics of ceftibuten (SCH 39720) in infants and children. Antimicrob Agents Chemother. 1991; 35:2078-84. [IDIS 288658] [PubMed 1759830]

36. Mandel EM, Casselbrant ML, Kurs-Lasky M et al. Efficacy of ceftibuten compared with amoxicillin for otitis media with effusion in infants and children. Pediatr Infect Dis J. 1996; 15:409-14. [IDIS 366219] [PubMed 8724062]

37. McAdoo MA, Rice K, Gordon GR et al. Comparison of ceftibuten once daily and amoxicillin-clavulanate three times daily in the treatment of acute exacerbations of chronic bronchitis. Clin Ther. 1998; 20:88-100. [IDIS 402073] [PubMed 9522107]

38. Ziering W, McElvaine P. Randomized comparison of once-daily ceftibuten and twice-daily clarithromycin in the treatment of acute exacerbation of chronic bronchitis. Infection. 1998; 26:68-75. [PubMed 9505188]

39. Aubier MA. Comparison of ceftibuten versus amoxicillin/clavulanate in the treatment of acute exacerbations of chronic bronchitis. Chemotherapy. 1997; 43:297-302. [IDIS 389325] [PubMed 9209787]

40. Lin CC, Affrime M, Radwanski E et al. Comparative bioavailability of ceftibuten in capsule and suspension forms. Clin Ther. 1996; 18:1139-49. [IDIS 380772] [PubMed 9001830]

41. Scaglione F, Pintucci JP, Demartini G et al. Ceftibuten concentrations in human tonsillar tissue. Eur J Clin Microbiol Infect Dis. 1996; 15:940-3. [PubMed 9031878]

42. Blumer JL, Forti WP, Summerhouse TL. Comparison of the efficacy and tolerability of once-daily ceftibuten and twice-daily cefprozil in the treatment of children with acute otitis media. Clin Ther. 1996; 18:811-20. [IDIS 376625] [PubMed 8930425]

43. Kishiyam JL, Adelman DC. The cross-reactivity and immunology of β-lactam antibiotics. Drug Saf. 1994; 10:318-27. [PubMed 8018304]

44. Thompson JW, Jacobs RF. Adverse effects of newer cephalosporins: an update. Drug Saf. 1993; 9:132-42. [PubMed 8397890]

45. De Abate CA, Perrotta RJ, Dennington ML et al. The efficacy and safety of once-daily ceftibuten compared with co-amoxiclav in the treatment of acute sinusitis. J Chemother. 1992; 4:358-63. [PubMed 1287138]

46. Kammer RB, Ress R. Randomized comparative study of ceftibuten versus cefaclor in the treatment of acute lower respiratory tract infections. Diagn Microbiol Infect Dis. 1991; 14:101-5. [PubMed 2013204]

47. McCabe R, Rumans L, Perrotta R et al. Comparison and efficacy and safety of ceftibuten and cefaclor in the treatment of pneumonia and bronchiectasis. J Chemother. 1993; 5:124-32. [PubMed 8515295]

48. Stool SE, Gerg AO, Berman S et al. Otitis media with effusion in young children. Clinical practice guideline No 12. AHCPR publication No. 94-0622. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services; 1994 Jul.

49. Williams RL, Chalmers TC, Stange KC et al. Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion: a meta-analytic attempt to resolve the brouhaha. JAMA. 1993; 270:1344-51. [IDIS 319598] [PubMed 8141875]

50. Paradise JL. Treatment guidelines for otitis media: the need for breadth and flexibility. Pediatr Infect Dis J. 1995; 14:429-35. [IDIS 348106] [PubMed 7638033]

51. Berman S. Otitis media in children. N Engl J Med. 1995; 332:1560-5. [IDIS 348227] [PubMed 7739711]

52. The Otitis Media Guideline Panel. Managing otitis media with effusion in young children. Pediatrics. 1994; 94:766-73. [IDIS 337882] [PubMed 7936917]

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55. Pichichero ME, Cohen R. Shortened course of antibiotic therapy for acute otitis media, sinusitis and tonsillopharyngitis. Pediatr Infect Dis J. 1997; 16:680-95. [IDIS 390075] [PubMed 9239773]

56. Tack KJ, Henry DC, Gooch WM et al et al. Five-day cefdinir treatment for streptococcal pharyngitis. Antimicrob Agents Chemother. 1998; 42:1073-5. [IDIS 404900] [PubMed 9593129]

57. Milatovic D, Adam D, Hamilton H et al. Cefprozil versus penicillin V in treatment of streptococcal tonsillopharyngitis. Antimicrob Agents Chemother. 1993; 37:1620-3. [IDIS 318765] [PubMed 8215273]

58. Aujard Y, Boucot I, Brahimi N et al. Comparative efficacy and safety of four-day cefuroxime axetil and ten-day penicillin treatment of group A beta-hemolytic streptococcal pharyngitis in children. Pediatr Infect Dis J. 1995; 14:295-300. [IDIS 345876] [PubMed 7603811]

59. Mehra S, Van Moerkerke M, Welck J et al. Short course therapy with cefuroxime axetil for group A streptococcal tonsillopharyngitis in children. Pediatr Infect Dis J. 1998; 17:452-7. [IDIS 408830] [PubMed 9655533]

60. Dajani AS, Kessler SL, Mendelson R et al. Cefpodoxime proxetil vs. penicillin V in pediatric streptococcal pharyngitis/tonsillitis. Pediatr Infect Dis J. 1993; 12:275-9. [PubMed 8483620]

61. Pichichero ME. Cephalosporins are superior to penicillin for treatment of streptococcal tonsillopharyngitis: is the difference worth it? Pediatr Infect Dis. 1993; 12:268-74.

62. Milatovic D. Evaluation of cefadroxil, penicillin and erythromycin in the treatment of streptococcal tonsillopharyngitis. Pediatr Infect Dis J. 1991; 10:S61-3. [PubMed 1945599]

63. Banfi A, Gabriele G, Hill-Juarez MJ et al. Multinational comparative trial of ceftibuten and trimethoprim-sulfamethoxazole in the treatment of children with complicated or recurrent urinary tract infections. Pediatr Infect Dis J. 1993; 12:S84-91.

64. Stein GE, Christensen S, Mummaw N. Treatment of acute uncomplicated urinary tract infection with ceftibuten. Infection. 1991; 19:125-7.

65. Reviewers’s comments (personal observations).

66. Schering, Kenilworth, NJ: Personal communication.

67. Dowell SF, Marcy SM, Phillips WR et al. Otitis media—principles of judicious use of antimicrobial agents. Pediatrics. 1998; 101:165-71.

68. Stool SE, Berg AO, Berman S et al for the Otitis Media Guideline Panel. Otitis media with effusion in young children. Clinical practice guideline. Number 12. AHCPR Publication No. 94-0622. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Resources. July 1994.

69. American Academy of Pediatrics and American Academy of Family Physicians Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004: 113:1451-65.

70. American Academy of Pediatrics, American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery, and American Academy of Pediatrics Subcommittee on Otitis Media with Effusion. Otitis media with effusion. Pediatrics. 2004: 113:1412-29.

a. AHFS Drug Information 2003. McEvoy GK, ed. Cephalosporins General Statement. American Society of Health-System Pharmacists; 2003:125-39.

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ceftibuten

ceftibuten

Generic Name: ceftibuten (SEF ti bue ten)

Brand Name: Cedax

OverviewSide EffectsInteractionsFor ProfessionalsMore…

What is ceftibuten?

Ceftibuten is in a group of drugs called cephalosporin (SEF a low spor in) antibiotics. It works by fighting bacteria in your body.

Ceftibuten is used to treat many different types of infections caused by bacteria.

Ceftibuten may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about ceftibuten?

Do not take this medication if you are allergic to ceftibuten, or to similar antibiotics, such as Ceftin, Cefzil, Keflex, Omnicef, and others.

Before taking this medication, tell your doctor if you are allergic to any drugs (especially penicillin). Also tell your doctor if you have kidney disease or a history of intestinal problems.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Ceftibuten will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

What should I discuss with my healthcare provider before taking ceftibuten?

Do not take this medication if you are allergic to ceftibuten or to other cephalosporin antibiotics, such as:

  • cefaclor (Raniclor);

  • cefadroxil (Duricef);
  • cefazolin (Ancef);
  • cefdinir (Omnicef);
  • cefditoren (Spectracef);
  • cefpodoxime (Vantin);
  • cefprozil (Cefzil);
  • cefuroxime (Ceftin);
  • cephalexin (Keflex); or
  • cephradine (Velosef).

Before taking ceftibuten, tell your doctor if you are allergic to any drugs (especially penicillins) or if you have.

  • kidney disease (or if you are on dialysis); or

  • a history of intestinal problems, such as colitis.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether ceftibuten passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The ceftibuten suspension (liquid) contains sucrose. Talk to your doctor before using this form of ceftibuten if you have diabetes.

How should I take ceftibuten?

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.

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.

Ceftibuten oral liquid should be taken at least 2 hours before or 1 hour after eating a meal.

This medication can cause you to have false results with certain medical tests, including urine glucose (sugar) tests. Tell any doctor who treats you that you are using ceftibuten.

Take ceftibuten for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Ceftibuten 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 ceftibuten oral liquid in the refrigerator. Do not allow it to freeze. Throw away any unused medication that is older than 14 days.

What happens if I miss a dose?

Take the medication as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include seizure (convulsions).

What should I avoid while taking ceftibuten?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Ceftibuten side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • diarrhea that is watery or bloody;

  • fever, chills, body aches, flu symptoms;
  • unusual bleeding;
  • blood in your urine;
  • seizure (convulsions);
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • jaundice (yellowing of the skin or eyes);
  • fever, swollen glands, rash or itching, joint pain, or general ill feeling;
  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
  • increased thirst, loss of appetite, swelling, weight gain, feeling short of breath, urinating less than usual or not at all.

Less serious side effects may include:

  • nausea, vomiting, stomach pain, upset stomach, belching, constipation, mild diarrhea;

  • stiff or tight muscles;
  • numbness or tingly feeling;
  • headache, dizziness, drowsiness, tired feeling;
  • feeling agitated, irritable, restless, or hyperactive;
  • dry mouth;
  • white patches or sores inside your mouth or on your lips;
  • unusual or unpleasant taste in your mouth;
  • stuffy nose, noisy breathing;
  • sleep problems (insomnia);
  • mild itching or skin rash;
  • vaginal itching or discharge;

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: ceftibuten side effects (in more detail)

Ceftibuten Dosing Information

Usual Adult Dose for Otitis Media:

400 mg orally every 24 hours for 10 days

Usual Adult Dose for Tonsillitis/Pharyngitis:

400 mg orally every 24 hours for 10 days

Usual Adult Dose for Bronchitis:

400 mg orally every 24 hours for 10 days

Usual Adult Dose for Cystitis:

400 mg orally every 24 hours for 7 days

Usual Adult Dose for Pneumonia:

200 mg orally every 12 hours for 7 to 14 days

Usual Adult Dose for Sinusitis:

400 mg orally every 24 hours for 10 to 14 days

Usual Pediatric Dose for Bronchitis:

>12 years: 400 mg orally every 24 hours for 10 days

Usual Pediatric Dose for Cystitis:

>12 years: 400 mg orally every 24 hours for 7 days

Usual Pediatric Dose for Pneumonia:

>12 years: 200 mg orally every 12 hours for 7 to 14 days

Usual Pediatric Dose for Sinusitis:

>12 years: 400 mg orally every 24 hours for 10 to 14 days

Usual Pediatric Dose for Otitis Media:

>6 months: 9 mg/kg/day (maximum 400 mg) every 24 hours for 10 days

Usual Pediatric Dose for Tonsillitis/Pharyngitis:

>6 months: 9 mg/kg/day (maximum 400 mg) every 24 hours for 10 days

What other drugs will affect ceftibuten?

Before taking ceftibuten, tell your doctor if you are taking any medication that reduces stomach acid, such as:

  • cimetidine (Tagamet);

  • famotidine (Pepcid);
  • omeprazole (Prilosec); or
  • ranitidine (Zantac), and others.

This list is not complete and there may be other drugs that can interact with ceftibuten. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start taking a new medication without telling your doctor.

Next Page → Side Effects

More ceftibuten resources

  • Side Effects
  • Pregnancy Warnings
  • Drug Interactions
  • Support Group
  • 3 Reviews - Add your own review/rating
  • ceftibuten MedFacts Consumer Leaflet (Wolters Kluwer)
  • ceftibuten Advanced Consumer (Micromedex) – Includes Dosage Information
  • Ceftibuten Professional Patient Advice (Wolters Kluwer)
  • Ceftibuten Monograph (AHFS DI)
  • Cedax Prescribing Information (FDA)

Compare ceftibuten with other medications

  • Bladder Infection
  • Bronchitis
  • Otitis Media
  • Pneumonia
  • Sinusitis
  • Strep Throat
  • Tonsillitis/Pharyngitis

Where can I get more information?

  • Your pharmacist can provide more information about ceftibuten.

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