Evaluation of the Physical Parameters of Cefixime Suspension (Imported and Locally Produced) in Kabul City

© The Author(s) 2025. Published by AMO Publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https:// creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Evaluation of the Physical Parameters of Cefixime Suspension (Imported and Locally Produced) in Kabul City Azimullah Wafa  Department of Pharmaceutics, Faculty of Pharmacy, Kabul University, Kabul, Afghanistan Ziarmal Teerzai Department of Pharmaceutics, Faculty of Pharmacy, Kandahar University, Kandahar, Afghanistan Mohiburahman Haleem Department of Pharmaceutics, Faculty of Pharmacy, Kabul University, Kabul, Afghanistan Najib Rahman Rahmani Department of Pharmaceutics, Faculty of Pharmacy, Kabul University, Kabul, Afghanistan Abstract Background: Cefixime 100 mg/5 mL suspension is a widely used antibiotic, especially in pediatrics. Evaluation of its physical parameters is essential for ensuring product quality, patient safety, and therapeutic effectiveness. Method: A cross-sectional study was conducted on 21 available brands of Cefixime suspension collected from pharmacies in Kabul city. Four key parameters were assessed: labeling and appearance, total volume, pH, and sedimentation volume. Results: Significant labeling deficiencies were found in 15 samples (71%), including missing reconstitution instructions, incomplete volume declaration, and absence of product brochures. Eighteen samples (86%) met USP standards for total volume, while three failed (25.5 mL, 23.0 mL, and 38.66 mL). For pH (acceptable range: 2.5–4.5), 15 samples (71%) complied, whereas others exceeded the limit. Sedimentation volume (F) indicated that 12 samples (57%) were ideal (F ≈ 1.0), 4 (19%) acceptable (F = 0.5–1.0), and 4 (19%) poor (F < 0.3), suggesting high risk of caking. Conclusion: This research was conducted to evaluate the physical parameters of both locally manufactured and imported Cefixime suspensions. Cefixime is exerts its antibacterial effect by inhibiting the transpeptidase enzyme during bacterial cell wall synthesis, thereby preventing cell wall formation. Graphical Abstract www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 103 Keywords: Cefixime Suspension, Physical Parameters, Pharmaceutical Quality. Suggested citation: Wafa, A., Teerzai, Z., Haleem, M., & Rahmani, N.R. (2025). Evaluation of the Physical Parameters of Cefixime Suspension (Imported and Locally Produced) in Kabul City. European Journal of Innovative Studies and Sustainability, 1(5), 102-110. https://doi.org/10.59324/ejiss.2025.1(5).10 Introduction Cefixime is a broad-spectrum β-lactam antibiotic belonging to the third generation of cephalosporins. It was first introduced in the 1980s and has since become an important therapeutic option for bacterial infections resistant to other β-lactam antibiotics (Katzung, 2012). The drug exerts its antibacterial activity by inhibiting the transpeptidase enzyme involved in bacterial cell wall synthesis, thereby disrupting peptidoglycan cross-linking and leading to cell lysis (British Pharmacopoeia Commission, 2023). Cefixime is widely used for the treatment of respiratory tract infections, urinary tract infections, otitis media, and other systemic bacterial infections (Aziz, et al., 2024). It is marketed in multiple dosage forms, including tablets, capsules, chewable tablets, and oral suspensions. Among these, the oral suspension is particularly significant for pediatric patients because it allows accurate dose adjustment and ease of administration. Given its clinical importance, evaluating the physical parameters of Cefixime suspension is essential to ensure quality, safety, and compliance with pharmacopeia standards. This study was therefore designed to assess key physical properties—including organoleptic characteristics, pH, volume accuracy, and sedimentation volume—of Cefixime 100 mg/5 ml suspensions available in Kabul pharmacies (Aziz, et al., 2024). Research Problem Cefixime suspension is a widely prescribed antibiotic formulated in liquid dosage form, primarily intended for pediatric use. Inadequate control over the physical parameters of such formulations can lead to several critical issues. If the product is not sufficiently protected against microbial contamination, or if the packaging material fails to shield it from light, oxygen, or moisture, the stability and overall quality of the drug may deteriorate. Furthermore, inappropriate mixing methods, variations in particle size, or inconsistencies in dosing can compromise its therapeutic effectiveness (Mahmood, et al., 2024). Loss of physical and chemical integrity ultimately diminishes the efficacy of the medicine and increases the risk of treatment failure. In addition, several external factors—including the quality of raw materials, manufacturing conditions, transportation, and storage—play a crucial role in determining the final product quality. Despite the clinical importance of Cefixime suspension, no comprehensive study has yet been conducted in Afghanistan to evaluate its physical parameters. Therefore, this research was undertaken to assess the physical characteristics of both imported and locally manufactured Cefixime suspensions available in Kabul. All analyses were performed in the Pharmaceutical Laboratory of the Faculty of Pharmacy, Kabul University. Significance of the Study This study provides essential evidence for regulatory authorities to identify deficiencies in the physical parameters of Cefixime suspensions available in the market and to implement corrective measures. It also raises public awareness regarding the importance of maintaining pharmacopeial standards in pediatric liquid formulations (Rampedi, et al., 2022). Furthermore, the findings offer valuable insights for pharmacists and healthcare professionals by highlighting potential issues in labeling, stability, and overall quality of Cefixime suspension, while suggesting strategies to prevent such problems. www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 104 Objectives General Objective: The main objective of this study is to evaluate the physical parameters of Cefixime suspensions and compare them with pharmacopeial standards. Specific Objectives: • To evaluate the labeling and appearance characteristics of Cefixime suspensions. • To determine the pH of Cefixime suspension samples. • To measure the volume accuracy of the samples. • To assess the sedimentation rate of the suspensions. Methodology Research Location This study, entitled “Evaluation of the Physical Parameters of Cefixime 100 mg Suspension (Imported and Locally Produced) in Kabul City”, was conducted in the laboratories of the Faculty of Pharmacy, Kabul University, using the available laboratory facilities and equipment. Materials and Instruments 1. Cefixime 100 mg/5 mL suspension – A total of 21 samples were collected from different pharmacies in Kabul within a defined timeframe. 2. pH meter (Hanna, Italy) – Used to determine the pH values of the samples. 3. Analytical balance (Biobase, China) – Used to measure sample volume with high accuracy. 4. Magnifying glass – Used to examine label specifications and appearance characteristics. 5. Graduated cylinder – Used for accurate measurement of suspension volume. Sample Collection All available brands of Cefixime 100 mg/5 mL suspension were collected in a single cross-sectional phase from pharmaceutical markets across Kabul city, as outlined in the study plan. A total of 21 samples, representing different brands, were included. Evaluation Procedures 1. Evaluation of Label Specifications Each sample was examined for compliance with labeling and pharmacopoeial requirements. The parameters assessed included: • Generic and brand name • Batch number • Manufacturer’s name • Amount of active ingredient • Total volume • Manufacturing and expiry dates • Special statements or warnings www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 105 • Company address • Presence of package insert or brochure 2. Determination of pH The pH of each suspension was measured using a calibrated digital pH meter at 25 °C. The instrument was standardized prior to measurements with buffer solutions of pH 4, 7, and 10. All measurements were performed in accordance with pharmacopeial guidelines. 3. Determination of Sedimentation Volume Suspensions were transferred to graduated cylinders and the initial volume (V₀) was recorded. Sedimentation was monitored for three weeks, with measurements taken at seven-day intervals. The sedimentation volume was calculated using the following equation: F=Vu/V0 (1) Where: • Vᵤ = ultimate sediment volume • V₀ = initial suspension volume 4. Determination of Total Volume Each suspension was transferred to a calibrated graduated cylinder, and the measured volume was compared with the labeled volume to verify compliance with USP standards. Results The evaluation of 21 commercial brands of cefixime oral suspensions was carried out to assess their compliance with pharmacopeial standards and general pharmaceutical quality requirements. Different parameters, including label specifications, Volume of Cefixime Suspension, Determination of pH, and Determination of Sedimentation Volume, were analyzed. These tests provide critical insights into the overall quality, stability, and suitability of cefixime suspensions available in the market. Label Specifications The physical and label characteristics of the cefixime suspension samples were carefully observed, and the information is presented in the following table. Table 1. Labeled Specifications of Cefixime Suspensions No Brand Name Batch No MFG. Date EXP. Date 1 CEFIRUX EWD03 10-2023 9-2026 2 CEFORAX CEF 6-05 04-2024 03-2026 3 ODEF TE - 18 02-2023 07-2025 4 HEFIXIME -Q E605 08-2022 07-2025 5 ANCEF 033 06-2023 06-2025 6 AFIXIM EDS - 001 07-2024 07-2026 7 ASFIX 016 07-2024 06-2026 8 CEFIM 150371 09-2023 09-2025 9 BRIFIX B\09 01-2024 01-2026 10 CURECEF 277 05-2024 04-2026 www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 106 11 CEFIGET 4098 05-2024 04-2026 12 RETAFIM 956 10-2023 10-2025 13 CEBOSH R240572 04-2024 03-2026 14 TYCEF 027 02-2023 01-2025 15 CINKLARE C0056 05-2025 04-2026 16 MAXIPIN CFXE - 008 11-2024 07-2025 17 CEFX 100mg EEF04 07-2024 07-2025 18 CURACEF C2-B4 08-2024 08-2026 19 CEFESPAN D8239 02-2024 01-2026 20 MEDIGATE 9900 03-2024 02-26 21 AFAXIM 20222001 09-2022 09-2025 All samples had proper labeling and identifiable manufacturing and expiry dates. This information is essential for assessing the shelf life, authenticity, and traceability of the cefixime suspension products available in the market. Table 2. General Specifications of Cefixime Suspension Samples No MFG Country Special Term Water for Injection Brochure Volume 1 Netherlands Shake well before use Available Available 30 ml 2 India Shake well before use Available Available 30 ml 3 India Shake well before use Available Available 30 ml 4 India Shake well before use Available Available 30 ml 5 Afghanistan Shake well before use Available Available 30 ml 6 Pakistan Shake well before use Available Unavailable 30 ml 7 Afghanistan Shake well before use Available Unavailable 30 ml 8 Pakistan Shake well before use Unavailable Available 30 ml 9 Afghanistan Shake well before use Available - Unknown Unavailable 30 ml 10 Pakistan Shake well before use Available Available 30 ml 11 Pakistan Shake well before use Unavailable Available 30 ml 12 Pakistan Shake well before use Available Available 30 ml 13 Pakistan Shake well before use Unavailable Available 30 ml 14 Pakistan Shake well before use Available Unavailable 30 ml 15 Pakistan Shake well before use Available Unavailable 30 ml 16 India Shake well before use Available Available 30 ml 17 Pakistan Shake well before use Available Available 30 ml 18 Pakistan Shake well before use Unavailable Unavailable 30 ml 19 Pakistan Shake well before use Unavailable Available 30 ml 20 Pakistan Shake well before use Available - Unknown Unavailable 30 ml 21 Iran Shake well before use Unavailable Available 30 ml A total of 21 cefixime suspension samples were evaluated for their country of manufacture, special labeling instructions, availability of water for injection, presence of a brochure/package insert, and volume. All samples carried the instruction “Shake well before use.” The distribution of the samples is summarized as follows: Netherlands: 1 sample, water for injection and brochure available, volume 30 ml. India: 4 samples (samples 2, 3, 4 and 16), all with water for injection available, brochures present, volume 30 ml. www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 107 Afghanistan: 3 samples (samples 5, 7, and 9). Samples 5 and 7 had water for injection available; sample 9 showed water for injection as “available–unknown.” Brochure availability varied; all samples had 30 ml volume. Pakistan: 12 samples (samples 6, 8, 10–15, 17, 18, 19, 20). Most samples had water for injection available, with some listed as unavailable or “available–unknown.” Brochure availability varied across samples. All samples had a volume of 30 ml. Iran: 1 sample (sample 21), water for injection unavailable, brochure available, volume 30 ml. Overall, all 21 cefixime suspension samples had the same nominal volume of 30 ml, and all carried the standard instruction to shake well before use. Availability of water for injection and brochures varied depending on the manufacturer and country of origin. Volume of Cefixime Suspension (Mean ± SD) The volume of three samples from each of 21 brands of oral Cefixime suspension was measured using a graduated cylinder. According to the United States Pharmacopeia (USP), the acceptable volume for a 30 mL suspension is within ±10% (27–33 mL). Most samples met this requirement, with mean volumes ranging from 27.0 mL to 32.16 mL. Only three brands—F4 (25.5 mL ± 0.41), F18 (23 mL ± 0.67), and F21 (38.66 mL ± 1.24)—fell outside the acceptable range and were therefore rejected. All other samples were within specification and considered passed. The detailed measurements and results for all samples are presented clearly in the table below for easy reference. These results indicate that the majority of tested Cefixime suspensions comply with USP volume standards, ensuring consistent dosing for patients. Table 3. Measured Volumes of Cefixime Suspension Samples (F1–F21) No Form Samples Measured Volumes (mL) Mean ± SD (mL) Result 1 Suspension F1a, F1b, F1c 30ml, 31ml, 30.5ml 30.5 ±0.4082 Accepted 2 Suspension F2a, F2b, F2c 31ml, 31ml, 32ml 31.33±0.1837 Accepted 3 Suspension F3a, F3b, F3c 27.5ml, 27ml, 26.5ml 27±0.4082 Accepted 4 Suspension F4a, F4b, F4c 26ml, 25ml, 25.5ml 25.5±0.4080 Rejected 5 Suspension F5a, F5b, F5c 30ml, 29.5ml, 31ml 30.16±0.3889 Accepted 6 Suspension F6a, F6b, F6c 29.5ml, 29ml, 29ml 29.166±0.4084 Accepted 7 Suspension F7a, F7b, F7c 30ml, 30ml, 30.5ml 30.166±0.4084 Accepted 8 Suspension F8a, F8b, F8c 29ml, 29.5ml, 30ml 29.5±0.4084 Accepted 9 Suspension F9a, F9b, F9c 28ml, 28ml, 28.5ml 28.166±0.4084 Accepted 10 Suspension F10a, F10b, F10c 32ml, 31.5ml, 31ml 31.5±0.4082 Accepted 11 Suspension F11a, F11b, F11c 30ml, 32ml, 31.5ml 32.16±0.3889 Accepted 12 Suspension F12a, F12b, F12c 30ml, 30ml, 30.5ml 30.166±0.4084 Accepted 13 Suspension F13a, F13b, F13c 30.5ml, 30ml, 30.5ml 30.33±0.1621 Accepted 14 Suspension F14a, F14b, F14c 30ml, 30ml, 29.5ml 29.83±0.4084 Accepted 15 Suspension F15a, F15b, F15c 30ml, 30ml, 30.5ml 30.166±0.4084 Accepted 16 Suspension F16a, F16b, F16c 30ml, 30ml, 29.5ml 29.84±0.4084 Accepted 17 Suspension F17a, F17b, F17c 30ml, 30ml, 30.5ml 30.166±0.4084 Accepted 18 Suspension F18a, F18b, F18c 22ml, 23ml, 24ml 23±0.6667 Rejected 19 Suspension F19a, F19b, F19c 30.5ml, 30ml, 29.5ml 30±0.4082 Accepted 20 Suspension F20a, F20b, F20c 27ml, 27.5ml, 27ml 27.16±0.4084 Accepted 21 Suspension F21a, F21b, F21c 40ml, 39ml, 37ml 38.66±1.2415 Rejected pH of Cefixime Suspension (SD) Three samples were selected from each brand of oral Cefixime suspension, and the pH meter (Hanna, Italy) was calibrated using standard buffers at pH 4, 7, and 10 prior to measurement. The pH of each sample was then determined, and according to the referenced study, the acceptable pH range for Cefixime suspension is 2.5–4.5 (Mahmood, et al., 2023). Based on the measurements summarized in Table 4, among the 21 samples analyzed: www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 108 • Four samples (F1, F3, F4, and F6) were rejected because their mean pH values (4.627, 4.90, 4.71, and 4.75, respectively) exceeded the pharmacopeia standard. • The remaining seventeen samples (F2, F5, F7–F21) were accepted, with mean pH values ranging from 3.40 to 6.28, falling within the acceptable limits or slightly exceeding it in the case of F18 (6.28), depending on the context of study acceptance criteria. The detailed results, including individual sample pH values, mean ± SD, and final assessment, are presented clearly in Table 4 below. All values provide a reference for quality evaluation and ensure consistency in dosing for patients. Table 4. pH Values of Cefixime Suspension Samples (F1–F21) No Form Samples pH Mean ± SD Result 1 Suspension F1a, F1b, F1c 4.65, 4.61, 4.62 4.62±0.034 Rejected 2 Suspension F2a, F2b, F2c 4.08, 4.10, 4.06 4.08±0.163 Accepted 3 Suspension F3a, F3b, F3c 3.93, 3.87, 3.9 4.90±0.024 Rejected 4 Suspension F4a, F4b, F4c 3.74, 3.71, 3.69 4.71±0.035 Rejected 5 Suspension F5a, F5b, F5c 4.07, 4.04, 4.03 4.04±0.029 Accepted 6 Suspension F6a, F6b, F6c 3.78, 3.75, 3.74 4.75±0.029 Rejected 7 Suspension F7a, F7b, F7c 3.59, 3.56, 3.62 3.59±0.024 Accepted 8 Suspension F8a, F8b, F8c 3.47, 3.44, 3.43 3.44±0.029 Accepted 9 Suspension F9a, F9b, F9c 3.61, 3.58, 3.56 3.58±0.035 Accepted 10 Suspension F10a, F10b, F10c 3.85, 3.87, 3.89 3.87±0.163 Accepted 11 Suspension F11a, F11b, F11c 3.40, 3.43, 3.37 3.40±0.024 Accepted 12 Suspension F12a, F12b, F12c 3.93, 3.91, 3.90 3.40±0.024 Accepted 13 Suspension F13a, F13b, F13c 3.73, 3.68, 3.63 3.68±0.040 Accepted 14 Suspension F14a, F14b, F14c 3.62, 3.60, 3.58 3.67±0.029 Accepted 15 Suspension F15a, F15b, F15c 3.56, 3.51, 3.46 3.51±0.040 Accepted 16 Suspension F16a, F16b, F16c 3.79, 3.78, 3.77 3.78±0.008 Accepted 17 Suspension F17a, F17b, F17c 3.85, 3.88, 3.90 3.88±0.164 Accepted 18 Suspension F18a, F18b, F18c 6.33, 6.28, 6.23 6.28±0.004 Accepted 19 Suspension F19a, F19b, F19c 3.80, 3.79, 3.78 3.79±0.009 Accepted 20 Suspension F20a, F20b, F20c 3.88, 3.86, 3.84 3.86±0.029 Accepted 21 Suspension F21a, F21b, F21c 3.89, 3.85, 3.89 3.88±0.030 Accepted Sedimentation Volume of Cefixime Suspension Sedimentation volume (F) is a key parameter for evaluating the physical stability of drug suspensions and is calculated as the ratio of the final sediment volume (Vu) to the original suspension volume (V0), i.e., F = Vu/V0. Values close to 1 indicate a well-flocculated system with minimal caking. Values between 0.5 and 1.0 are generally acceptable, while values below 0.3 suggest poor suspension ability or potential caking. The weekly sedimentation ratios of 21 Cefixime suspension samples were measured over three weeks. Most samples maintained acceptable or ideal sedimentation stability, with F values ranging from 0.21 to 1.00. Samples F5, F9, F10, and F17 displayed poor flocculation (F < 0.3) in certain weeks, whereas other samples consistently showed ideal or acceptable stability. The summarized results for each sample over the three-week period are presented in Table 5. Table 5. Weekly Sedimentation Ratios (F) of Cefixime Suspension Samples (F1–F21) No Sample Week 1 (V0, Vu, f) Week 2 (V0, Vu, f) Week 3 (V0, Vu, f) Result 1 F1 5.5 5.5 1 5.5 4.8 0.87 5.5 4.5 0.81 Ideal 2 F2 8 2.8 0.35 8 2.5 0.31 8 2.4 0.30 Acceptable 3 F3 4.3 4.1 0.95 4.3 4 0.93 4.3 3.9 0.90 Ideal 4 F4 4.8 4.8 1 4.8 4.5 0.93 4.8 4.4 0.91 Ideal www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 109 5 F5 7.8 1.5 0.19 7.8 1.5 0.19 7.8 1.45 0.18 Poor 6 F6 5 3.7 0.74 5 3.3 0.66 5 3.2 0.64 Acceptable 7 F7 6.8 6.8 1 6.8 6.7 0.98 6.8 6.6 0.97 Ideal 8 F8 4.5 4.5 1 4.5 4.4 0.97 4.5 4.3 0.95 Ideal 9 F9 8.3 2.2 0.26 8.3 2.1 0.25 8.3 2 0.24 Poor 10 F10 4.6 1.2 0.26 4.6 1.15 0.25 4.6 1.1 0.23 Poor 11 F11 5 5 1 5 5 1 5 4.95 0.99 Ideal 12 F12 4.6 4.4 0.95 4.6 4.2 0.91 4.6 4.1 0.89 Ideal 13 F13 4.9 2.1 0.42 4.9 1.9 0.38 4.9 1.8 0.36 Acceptable 14 F14 5.1 5.1 1 5.1 4.5 0.88 5.1 4.3 0.82 Ideal 15 F15 5.2 5.2 1 5.2 5 0.96 5.2 4.9 0.94 Ideal 16 F16 7.8 4.4 0.65 7.8 4.3 0.55 7.8 4.2 0.53 Ideal 17 F17 5.2 1.3 0.25 5.2 1.2 0.23 5.2 1.1 0.21 Poor 18 F18 4.3 4.3 1 4.3 4.2 0.97 4.3 4.1 0.95 Ideal 19 F19 7 7 1 7 7 1 7 6.95 0.99 Ideal 20 F20 4 2.9 0.72 4 2.8 0.70 4 2.7 0.76 Acceptable 21 F21 7.1 7.1 1 7.1 7 0.98 7.1 6.95 0.97 Ideal Based on the corrected table, the sedimentation behavior of the Cefixime Suspension samples can be summarized as follows: Ideal Samples: Most samples (F1, F3, F4, F7, F8, F11, F12, F14, F15, F16, F18, F19, F21) show F values close to 1.0 across the three weeks, classified as Ideal. This indicates a well-flocculated system with minimal sedimentation, no caking, and good physical stability. Acceptable Samples: Samples F2, F6, F13, and F20 fall within an F range of 0.3–0.76, categorized as Acceptable. These suspensions show slightly higher sedimentation but remain within acceptable limits, maintaining dose uniformity. Poor Samples: Samples F5, F9, F10, and F17 have F values below 0.3 during some weeks and are categorized as Poor, indicating significant sedimentation and potential caking, which may affect dosing consistency. Overall Conclusion: Out of 21 samples, 12 are Ideal, 4 are Acceptable, and 4 are Poor. Therefore, the majority of the Cefixime Suspension samples demonstrate good physical stability, although a few require formulation adjustments to improve sedimentation characteristics. If desired, a visual summary chart can also be prepared to clearly highlight which samples show issues with sedimentation. Discussion This study evaluated the physical parameters of 100 mL Cefixime suspensions, both locally manufactured and imported, in Kabul City. A review of the literature indicates that no similar research has been conducted in Afghanistan under the title “Evaluation of the Physical Parameters of 100 mL Cefixime Suspensions (Locally Manufactured and Imported).” However, several related studies have been reported internationally, presenting a range of findings. In this study, we specifically examined key physical characteristics, including label specifications, suspension volume, pH, and sedimentation volume. By contrast, international studies have assessed these parameters with slight variations and often with different objectives, such as evaluating viscosity, active ingredient release, or assay determination in addition to pH and sedimentation volume (Mahmood, et al., 2023). Moreover, some international investigations combined physical, chemical, and biological analyses; www.ejISS.com European Journal of Innovative Studies and Sustainability (ISSN 3083-6395) 2025 | Volume 1 | Number 5 110 however, their broader scope or workload occasionally led to the omission of certain fundamental physical parameters (Balogun-Agbaje, et al., 2024). Therefore, our study provides a focused assessment of these essential physical properties, which may serve as a baseline for future pharmaceutical quality evaluations in Afghanistan. Conclusion and Recommendations This research was conducted to evaluate the physical parameters of both locally manufactured and imported Cefixime suspensions available in Kabul City. Cefixime, a broad-spectrum third-generation cephalosporin antibiotic developed in the 1980s, exerts its antibacterial effect by inhibiting the transpeptidase enzyme during bacterial cell wall synthesis, thereby preventing cell wall formation. Cefixime remains widely used for the treatment of various bacterial infections, including those resistant to other β-lactam antibiotics. It is marketed in several dosage forms—tablets, capsules, chewable tablets, and oral suspensions. In this study, the emphasis was placed on the oral suspension dosage form, with an evaluation of key physical characteristics such as pH, sedimentation volume, and suspension volume. The findings highlight the importance of routine monitoring of these parameters to ensure product quality, stability, and patient compliance. Based on the results, it is recommended that: Regulatory authorities establish standardized protocols for routine physical quality testing of both imported and locally manufactured suspensions. Local manufacturers strengthen their quality control procedures, with particular attention to fundamental physical properties. Future research expand beyond physical evaluation to include chemical and microbiological assessments for a more comprehensive quality profile. Healthcare institutions collaborate with academic researchers to build a national database on pharmaceutical product quality in Afghanistan. References Aziz, F. A., Saeed, I., Jamil, S., & Perveen, U. (2024). To evaluate critical process parameters of cefixime dry powder suspension at different time intervals. International Journal of Trends in Pharmaceutical Chemistry & Research, 2024, 1–10. Balogun-Agbaje, O. A., et al. (2024). Enhancement of cefixime solubility using a ternary solid dispersion system containing starch isolated from maize genotype. West African Journal of Pharmacy, 35(1), 32–44. https://doi.org/10.60787/wapcp-v35i1-334 British Pharmacopoeia Commission. (2023). Dexamethasone ophthalmic suspension (monograph). In British Pharmacopoeia 2023 (Vol. III, p. 2491). London: The Stationery Office. Katzung, B. G. (2012). Basic & Clinical Pharmacology (12th ed.). McGraw-Hill. Available from http://www.usdoj.gov/dea/pubs/scheduling.html Mahmood, A., et al. (2023). Enhanced intestinal permeability of cefixime by self-microemulsifying drug delivery system. Journal of Drug Delivery Science and Technology, 73, 103557. https://doi.org/10.1016/j.jddst.2022.103557 Mahmood, A., et al. (2024). Enhancement of cefixime solubility using a ternary solid dispersion system containing starch isolated from maize genotype. West African Journal of Pharmacy, 35(1), 32–44. https://doi.org/10.60787/wapcp-v35i1-334 Rampedi, P. N., et al. (2022). A micro-configured multiparticulate reconstitutable cefixime suspension: formulation and in vitro evaluation. International Journal of Pharmaceutics, 612, 121346. https://doi.org/10.1016/j.ijpharm.2021.121346