II. Indications
- Abdominal Surgery prophylaxis
- Colorectal surgery prophylaxis
III. Mechanism
- Antibiotics in this group are Cephamycin derivatives
-
Antibiotic coverage spectrum
- Gram Positive activity (but less than Second Generation Broad-spectrum Cephalosporins such as Cefuroxime)
- Gram Negative coverage
- Anaerobic coverage (e.g. Bacteroides)
IV. Dosing: Adult
- Typical Dose
- Give 1 to 2 g IV every 6 to 8 hours
- High Dose (Severe Infections)
- Give 3 g IV every 6 hours
- Surgical Prophylaxis
- Give 2 g IV 30 to 60 min before surgery (or for Cesarean Section, after Umbilical Cord clamped)
- May continue 2 g IV every 6 hours for 24 hours
-
Renal Dosing
- eGFR 30 to 50 ml/min: 1 to 2 g IV every 8 to 12 hours
- eGFR 10 to 29 ml/min: 1 to 2 g IV every 12 to 24 hours
- eGFR 5 to 9 ml/min: 0.5 to 1 g IV every 12 to 24 hours
- eGFR <5 ml/min: Load 1 to 2 g IV, then 0.5 g IV every 24 to 48 hours
- Give additional 1 to 2 g IV after Hemodialysis
V. Dosing: Child (age >3 months)
- Typical Dose
- Give 80 to 100 mg/kg/day IV divided every 6 to 8 hours
- High Dose (severe infections)
- Give 160 mg/kg/day IV divided every 6 to 8 hours
VI. Adverse Effects
- Lab abnormalities in children after high dose regimens
- Eosinophilia
- Aspartate Aminotransferase (AST) increased
VII. Safety
- Pregnancy Category B
- Safe in Lactation
VIII. Resources
IX. References
- (2012) Presc Lett, Resource #280706, Comparison of Cephalosporins
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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| Definition (NCI) | 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. |
| Definition (MSH) | A semisynthetic cephamycin antibiotic resistant to beta-lactamase. |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | D002440 |
| SnomedCT | 372780005, 57670008 |
| LNC | LP15205-5, MTHU002759 |
| English | Cefoxitin, 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 3-(((aminocarbonyl)oxy)methyl)-7-methoxy-8-oxo-7-((2-thienylacetyl)amino)-, (6R-cis)-, cefoxitin (medication), Cefoxitin [Chemical/Ingredient], cefOXitin, CefOXitin, cefoxitin, CEFOXITIN, Cefoxitin (product), Cefoxitin (substance) |
| Swedish | Cefoxitin |
| Czech | cefoxitin |
| Finnish | Kefoksitiini |
| Russian | TSEFOKSITIN, ЦЕФОКСИТИН |
| Japanese | セフォキシチン, セホキシチン |
| Polish | Cefoksytyna |
| Spanish | cefoxitina (producto), cefoxitina (sustancia), cefoxitina, Cefoxitina |
| French | Céfoxitine |
| German | Cefoxitin |
| Italian | Cefoxitina |
| Portuguese | Cefoxitina |
