COMPOSITIONEach film coated bilayer tablet contains : Cefixime IP as Trihydrate eq. To anhydrous cefixime 200mg Dicloxacilin sodium IP eq. To Dicloxacillin( As sustained release form) 500mg Color : Sunset yellow FCF & titanium dioxide IPDESCRIPTIONCefixime is an oral third generation cephalosporin antibiotic. Chemically, it is (6R,7R)-7-{[2-(2-amino-1,3- thiazol-4-yl)-2-(carboxymethoxyimino) acetyl]amino}-3- ethenyl-8-oxo-5-thia-1-azabicyclo-[4.2.0]oct-2-ene-2- carboxylic acid, clinically used in the treatment of susceptible infections including gonorrhoea, otitis media, pharyngitis, lower respiratory-tract infections such as bronchitis, and urinary-tract infections.

Dicloxacillin {ER} is a narrow-spectrum beta-lactam antibiotic of the penicillin class. It is used to treat infections caused by susceptible Gram-positive bacteria. It is active against beta-lactamase-producing organisms such as Staphylococcus aureus, which would otherwise be resistant to most penicillins.

INDICATIONS AND USAGE

#For the treatment of adult patients with Upper and Lower respiratory tract infections#skin and soft tissue infectionsDOSAGE AND ADMINISTRATIONTablet should be taken orally, twice a day for upto 5-7 days.

RATIONALE OF COMBINATIONThis combination Penetrates well into body tissues and fluids.This help in effective bacteridial action.Moreover, when pencicillinase -resistant penicillin(dicloxacillin) is also used,activity against B lactamse producing strains is enhanced. Thus in order to enhance the empiric profile of cefixime which has less potent activity against Gram +ve organisms, suc as Staphylococci,the addition of penicillianse resistant penicillin (Dicloxacillin) which provides added effect of Gram +ve coverage, with MIC90 values asw follows: S.aureus 0.1 mcg/ml; S.epidermis 0.1 mcg/ml;Str. pyogenes 0.1 mcg/ml; Str. pneumonniae 0.25 mcg/ml; N.gonorrheoae 0.1 mcg/ml converts the combination into a very broad spectrum antibiotic.

Advantages Over Plain CefiximeCefixime has a poor activity against S.aureus which preclude its use as a first choice in the treatment of soft tissue infections, toxic shock syndrome and food poisoning caused by S.aureus since dicloxacillin is highly effective for S.aureus CEFIXIME + DICLOXACILLIN combination enhanced use of this combination in skin infections, GI tract infections.

Advantages over Amoxycillin & Clavulanic AcidPseudomonas aeruginosa has become an important cause of infection, especially in patients with compromised host defense mechanisms.It is a frequent cause of nosocomial infections such as pneumonia,urinary tract infections (UTIs), and bacteremia.Pseudomonalinfections are compliccated and can be life threating.Amoxicillin and clavulanic acid combination is ineffective for this strain which reduces its effectiveness as compared to cefixime and dicloxacillin combination efffective against this strain . Moreover M.I.C values for Amoxycillin and Clavulanate combination is 0.5mcg/ml for N.gonorrhea which implies this combination being active at higher dose than CEFIXIME and DICLOXACILLIN combination against same species which has M.I.C values of 0.1 mcg/ml for both species thus confirming CEFIXIME and DICLOXACILLIN superior effectiveness.

Advantages of CEFIXIME + DICLOXACILLIN OVER AzithromycinAZITHROMYCIN is a bacteriostatic drug thus inhibits bacterial growth but CEFIXIME and DICLOXACILLIN combination is a bactericidal medication and kills bacteria S.PYOGENES ( Group A streptococci ) is a resistant to azithromycin. Azithromycin was inactive against Enterococci ( group D streptococci). S.Viridans is also resistant overall to azithromycin. But cefixime and dicloxacillin combination medication is very effective against S.PYOGENES with MIC value 0.1 mcg/ml .GROUP A STREPTOCOCCI and S.viridans are responsible for throat infections, sinusitis,tonsillitis,pneumonia and scarlet fever.Moreover AZITHROMYCIN MIC value against S.aureus is 0.25-1 mcg /ml however of cefixime and dicloxacillin is 0.1 mcg/ml thus this combination is more effective in skin infections caused by S.aureus.

CEFIXIME + DICLOXACILLIN is an efficacous and better treatmentFor Normal & Chronic Type of Bacterial Infections-*Otitis Media caused by Haemophilus influenzae( beta- lactamase +ve & -ve strains), Moraxella catarrhal is (most of which are beta- lactamase +ve) and Strep.Pyogenes.*Pharyngitis and Tonsillits caused by Strep.Pyogenes.*Acute Bronchitis and Acute Exacerbations of Chronic Bronchitis caused by Streptococcus pneumoniae and Haemophilus influenzae( beta - lactamase +ve & -ve strains).*Beta Lactamase producing pathogens- In the treatment of infections with Staph.aureus and Bacteroides fragilis or with beta-lactamase producing H.influenzae and E.coli.*Abcess(pus formation)*Injuries*Osteomylitis*Skin and soft tissue infections*Ensures complete bacterial death*Medication with least side effects