Cefoxitin

Pneumonia, Intra-abdominal infections, UTI, Pelvic inflammatory disease, Lower Respiratory Tract Infections, Endometritis, Pelvic cellulitis, Gonorrhea, Lung abscess, Skin and skin structure infections, Bone and/or joint infections, Prophylaxis of surgical infections, Gynecological infections

Adult: IV Complicated urinary tract infection, Pyelonephritis 2 g every 4–6 hours; maximum 12 g per day IV Prophylaxis of endometritis at cesarean section 2 g as a single dose as soon as the umbilical cord is clamped. May be repeated 4 and 8 hr later if needed. IV/IM Susceptible infections 1-2 g 4-8 hrly. Up to 12 g/day for severe infections. Surgical prophylaxis 2 g 30-60 mins pre-op, then 6 hrly, usually for <24 hr. IM Uncomplicated UTI 1 g twice daily. Uncomplicated gonorrhea W/ oral probenecid: 2 g as a single dose.

Child: IV, IM 80–160 mg/kg/day, max 12 g/day q6–8h

Renal impairment: Loading dose: 1-2 g. Maintenance dose: According to CrCl. Hemodialysis patients: Repeat loading dose after each dialysis session. CrCl (ml/min) <5 0.5-1 g every 24-48 hr. 5-9 0.5-1 g every 12-24 hr. 10-29 1-2 g every 12-24 hr. 30-50 1-2 g every 8-12 hr.

IV Preparation Intermittent IV: reconstitute 1or 2 g w/ 10-20 mL SWI Continuous infusion: add reconstituted soln to D5W or NS IM Preparation Reconstitute by adding 2 mL SWI or 0.5-1% lidocaine HCl injection (without epinephrine) to each g of cefoxitin to obtain an approx 400 mg/mL solution IV Administration Injection: directly into a vein over 3-5-min or slowly into tubing of a compatible IV infusion solution IM Administration Deep into a large muscle (eg, upper outer quadrant of gluteus maximus)

Hypersensitivity to cephalosporins.

Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity); superinfections, and promotion of non-susceptible organisms may occur with prolonged use or repeated therapy Monitor renal and haematologic status.

Not Classi Pregnancy Available data from published prospective cohort studies, case series, and case reports with cephalosporin use in pregnant women have not established drug- associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes Maternal gonorrhea may be associated with preterm birth, low neonatal birth weight, chorioamnionitis, intrauterine growth restriction, small for gestational age and premature rupture of membranes; perinatal transmission of gonorrhea to offspring can result in infant blindness, joint infections, and bloodstream infections. Lactation Limited data from published literature report presence of drug in human milk For an infant fed exclusively with human milk, estimated infant daily dose through breastfeeding is less than 0.1% of maternal daily IV dose Minimal data available on effects of drug on breastfed infant; none of these reports suggest serious safety concerns No data are available on effects of drug on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for cefoxitin and any potential adverse effects on breastfed infant from drug or from underlying maternal condition

Reduces renal clearance w/ probenecid. Concurrent use of nephrotoxic agents (e.g. aminoglycosides, colistin, polymyxin B, vancomycin) may increase the risk of nephrotoxicity. Contraindicated (0) Serious (4) BCG vaccine live chloramphenicol cholera vaccine microbiota oral

1-10% Diarrhea <1% Anemia,Eosinophilia,Transient leukopenia,Thrombocytopenia,SCr & BUN increased,Elevated LFT's Potentially Fatal: Pseudomembranous collitis.

Cefoxitin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial cell death.