Trade Names:Cefoxitin Sodium- Powder for Injection 1 g (2.3 mEq sodium/g)- Powder for Injection 2 g (2.3 mEq sodium/g)- Powder for Injection 10 g (2.3 mEq sodium/g)- Injection 1 g- Injection 2 g
Inhibits mucopeptide synthesis in bacterial cell wall.
C max is 110 mcg/mL (1 g dose). T max is 5 min.
Passes into pleural and joint fluids and is detectable in antibacterial concentrations in the bile. Excreted in human milk (low concentrations).
The t ½ is 41 to 59 min (IV). About 85% is excreted unchanged by the kidneys in 6 h.
The t ½ is increased. Dosage adjustment is recommended.
Treatment of infections of lower respiratory tract, urinary tract, skin and skin structures, bone and joint; treatment of intra-abdominal infections, gynecological infections, and septicemia caused by susceptible microorganisms; perioperative prophylaxis. Many infections caused by gram-negative bacteria resistant to some cephalosporins and penicillins respond to cefoxitin.
Hypersensitivity to cephalosporins.
IV/IM 1 to 2 g every 6 to 8 h.Children 3 mo of age and older
IV/IM 80 to 160 mg/kg/day in divided doses every 4 to 6 h (max, 12 g/day).Surgical ProphylaxisAdults
IV/IM 2 g just prior to surgery, then 2 g every 6 h for 24 h.Children 3 mo of age and older
IV/IM 30 to 40 mg/kg just prior to surgery, then 30 to 40 mg/kg every 6 h for 24 h.
Store powder in vials between 36° and 77°F. Store the premixed IV solution at or below −4°F. The dry powder and solutions tend to darken, depending on storage conditions; however, product potency is not adversely affected.
May increase risk of nephrotoxicity.Probenecid
Inhibition of renal excretion of cefoxitin.
Do not add aminoglycosides to cefoxitin solutions because inactivation of both drugs may result; administer at separate sites if concurrent therapy is indicated.
May cause false-positive urine glucose test results with Benedict solution, Fehling solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix , Tes-tape ); false-positive test result for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs test result in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values. High concentrations may interfere with creatinine concentrations measured by the Jaffe reaction, producing false results; do not analyze serum samples for creatinine if obtained within 2 hr of drug administration.
Nausea; vomiting; diarrhea; colitis, including pseudomembranous colitis.
Renal function impairment; elevated renal function tests; pyuria; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy.
Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; hemolytic anemia; aplastic anemia; hemorrhage.
Hepatic function impairment; jaundice; abnormal LFT results.
Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness–like reactions (eg, skin rashes, polyarthritis; arthralgia, fever); phlebitis, thrombophlebitis, and pain at injection site.
Monitor for coagulation abnormalities. Elevated PT or abnormal platelet count may occur. If bleeding occurs and PT is prolonged, vitamin K may be indicated.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.
Category B .
Excreted in breast milk.
In children 3 mo of age and older, high doses of cefoxitin have been associated with increased incidence of eosinophilia and elevated AST.
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.
Use drug with caution. Dosage adjustment based on renal function may be required.
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Consider in patients in whom diarrhea develops.
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