Meiact (Cefditoren Pivoxil)

Cefditoren pivoxil is indicated for bacterial infections affecting the respiratory tract and skin structures.

• Acute bacterial sinusitis: reduces symptoms and eradicates the causative bacteria.
• Community‑acquired pneumonia: provides bacterial coverage to resolve pulmonary infection.
• Acute bacterial exacerbations of chronic bronchitis: helps control worsening respiratory symptoms.
• Skin and soft‑tissue infections: treats susceptible Gram‑positive and Gram‑negative organisms.

• Cefditoren pivoxil is a prodrug that is rapidly hydrolysed after oral absorption to the active cephalosporin cefditoren. The active molecule binds to penicillin‑binding proteins on susceptible bacteria, inhibiting the final transpeptidation step of peptidoglycan synthesis, which weakens the cell wall and leads to bacterial lysis and death.

Cefditoren pivoxil may cause a range of adverse reactions.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhoea: loose stools, often self‑limiting.
• Headache: transient cranial discomfort.
• Rash: mild skin erythema or itching.

Serious or Rare Side Effects

• Clostridioides difficile‑associated colitis: severe diarrhoea requiring medical attention.
• Anaphylaxis: rapid onset of swelling, breathing difficulty, and hypotension.
• Stevens‑Johnson syndrome: severe skin blistering and mucosal involvement.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Neutropenia: marked reduction in white blood cells.

Before prescribing Meiact, consider the following safety measures.

• Assess renal function: adjust use in patients with severe renal impairment.
• Monitor for allergic reactions: discontinue if signs of hypersensitivity appear.
• Use with caution in hepatic disease: observe liver function tests periodically.
• Avoid in patients with known hypersensitivity to cephalosporins or penicillins.
• Store at ambient temperature: keep in the original pack, protect from moisture and light.

Cefditoren pivoxil can interact with several medicines; awareness helps prevent adverse outcomes.

Major Interactions (Avoid)

• Probenecid: may increase cefditoren plasma concentrations and toxicity.
• Warfarin: can potentiate anticoagulant effect, increasing bleeding risk.
• Oral contraceptives: may reduce contraceptive efficacy, risking unintended pregnancy.

Moderate Interactions (Monitor Closely)

• Macrolide antibiotics (e.g., erythromycin): may increase gastrointestinal side‑effects.
• Antacids containing aluminium or magnesium: can reduce cefditoren absorption.
• Loop diuretics (e.g., furosemide): may heighten risk of electrolyte disturbances.