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Cefoxitin; Indications/Uses, Dosage, Side Effects, Interactions

Cefoxitin is a semisynthetic, broad-spectrum, second-generation cephalosporin with antibacterial activity. Cefoxitin binds to and inactivates penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis.[Pubchem]

Mechanism of action of Cefoxitin

The bactericidal action of cefoxitin results from inhibition of cell wall synthesis. Cefoxitin is a cephamycin antibiotic often grouped with the second-generation cephalosporins. It is active against a broad range of gram-negative bacteria including anaerobes. The methoxy group in the 7a position provides cefoxitin with a high degree of stability in the presence of beta-lactamases, both penicillinases, and cephalosporinases, of gram-negative bacteria. Cefoxitin is a semisynthetic, broad-spectrum, second-generation cephalosporin with antibacterial activity. Cefoxitinbinds to and inactivates penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis.

Indications of Cefoxitin

Abscess, Intra-Abdominal
For the treatment of serious infections caused by susceptible strains microorganisms.
Lower respiratory tract infections, including pneumonia and lung abscess,s
Urinary tract infections caused by Escherichia coli, Klebsiella species,
Intra-abdominal infections, including peritonitis and intra-abdominal abscess,
Gynecological infections, including endometritis, pelvic cellulitis, and pelvic inflammatory disease caused
Bacterial Infections
Bloodstream Infections
Bone and Joint Infections
Aspiration Pneumonia Cesarean Section
Bronchitis
Tonsillitis
Endometritis
Flu caused by Influenza
Infected animal bite
Intra-Abdominal Infections
Lower respiratory tract infection bacterial
Peritonitis
Pneumonia
Skin and Subcutaneous Tissue Bacterial Infections
Skin and skin structure infections caused by Staphylococcus aureus

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Contra-Indications of Cefoxitin

Clostridium difficile infection
The decrease in the blood-clotting protein prothrombin
Severe renal impairment
Inadequate vitamin K
Hemolytic anemia
Liver problems
Interstitial nephritis
Subacute cutaneous lupus erythematosus
Systemic lupus erythematosus
Allergies cephalosporins & beta-lactams

Dosage of Cefoxitin

Strengths: 1 g; 2 g; 10 g; 1 g/50 mL; 2 g/50 mL

Aspiration Pneumonia

Uncomplicated infections (bacteremia is absent or unlikely): 1 g IV every 6 to 8 hours
Moderately severe or severe infections: 1 g IV every 4 hours or 2 g IV every 6 to 8 hours
Severe, life-threatening infections: 2 g IV every 4 hours or 3 g IV every 6 hours

Intraabdominal Infection

Uncomplicated infections (bacteremia is absent or unlikely): 1 g IV every 6 to 8 hours
Moderately severe or severe infections: 1 g IV every 4 hours or 2 g IV every 6 to 8 hours
Severe, life-threatening infections: 2 g IV every 4 hours or 3 g IV every 6 hours

Joint Infection

Uncomplicated infections (bacteremia is absent or unlikely): 1 g IV every 6 to 8 hours
Moderately severe or severe infections: 1 g IV every 4 hours or 2 g IV every 6 to 8 hours
Severe, life-threatening infections: 2 g IV every 4 hours or 3 g IV every 6 hours.

Pneumonia

Uncomplicated infections (bacteremia is absent or unlikely): 1 g IV every 6 to 8 hours
Moderately severe or severe infections: 1 g IV every 4 hours or 2 g IV every 6 to 8 hours
Severe, life-threatening infections: 2 g IV every 4 hours or 3 g IV every 6 hours.

Skin and Structure Infection

Uncomplicated infections (bacteremia is absent or unlikely): 1 g IV every 6 to 8 hours
Moderately severe or severe infections: 1 g IV every 4 hours or 2 g IV every 6 to 8 hours
Severe, life-threatening infections: 2 g IV every 4 hours or 3 g IV every 6 hours

Urinary Tract Infection

Uncomplicated infections (bacteremia is absent or unlikely): 1 g IV every 6 to 8 hours
Moderately severe or severe infections: 1 g IV every 4 hours or 2 g IV every 6 to 8 hours
Severe, life-threatening infections: 2 g IV every 4 hours or 3 g IV every 6 hours.

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Pediatric Intraabdominal Infection

3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Pediatric Osteomyelitis

3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Side Effects of Cefoxitin

The most common

local tenderness or pain at the site of injection
skin color change, mild diarrhea
mild nausea
loss of appetite
vaginal discharge and itching
swelling of feet or legs
chest pain
constipation
cough
diarrhea or loose stools
difficulty with breathing
dizziness
heartburn

More common

Abdominal or stomach pain, discomfort, or tenderness
chills or fever
difficulty with moving
headache, severe and throbbing
joint or back pain
muscle aching or cramping
muscle pains or stiffness
chest pressure or squeezing pain in chest
excessive sweating
feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
sudden tingling or coldness in an arm or leg
sudden slow or difficult speech
sudden drowsiness or need to sleep
fast breathing
sharp pain when taking a deep breath
fast or slow heartbeat
coughing up blood
rust colored urine
decreased amount of urine

Rare

Anxiety
change in vision
seizures
abnormal or fast heart rate
tremors
weight loss
chest pain or tightness
confusion
cough
Agitation
arm, back, or jaw pain
blurred vision
chest pain or discomfort
convulsions
extra heartbeats
fainting
hallucinations
headache
irritability
lightheadedness
mood or mental changes
muscle pain or cramps

Drug Interactions of Cefoxitin

Cefoxitin may interact with following drugs, supplements, & may change the efficacy of drugs

aminoglycoside antibiotics (e.g., gentamicin, tobramycin)
probenecid
typhoid vaccine
cholera vaccine,
amoxicillin
Aspirin Low Strength (aspirin)
Diphenhydramine
Rosuvastatin
Duloxetine
Albuterol
Topiramate
Carbamazepine
Vitamin B12 (cyanocobalamin)
Vitamin D3 (cholecalciferol)
Alprazolam
Cetirizine
Phenprocoumon
Picosulfuric acid
Warfarin

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Pregnancy Catagory of Cefoxitin

FDA Pregnancy Category B

Pregnancy

It is not known if cefoxitin is safe for use by pregnant women. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Lactation

This medication may pass into breast milk. If you are a breastfeeding mother and are taking cefoxitin it may affect your baby. Talk to your doctor about whether you should continue breastfeeding. It is not known if cefoxitin is safe for children under 6 months of age.