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Cefoxitin sodium
Cefoxitin sodium (Mefoxin)
Cefoxitin sodium
(seh-FOX-ih-tin)
Pregnancy Category: B Mefoxin (Rx)

Classification: Cephalosporin, second-generation

See Also: See also Anti-Infectives and Cephalosporins.

Action/Kinetics: Broad-spectrum cephalosporin that is penicillinase- and cephalosporinase-resistant and is stable in the presence of beta-lactamases. Peak serum level after 1 g IV: 110 mcg/mL. t1/2: 40-60 min; 85% of drug excreted unchanged in urine after 6 hr.

Uses: (1) Lower respiratory tract infections (pneumonia and abcess) due to Streptococcus pneumoniae other streptococci (excluding enterococci such as S. faecalis), Staphylococcus aureus, Escherichia coli, Klebsiella species, Haemophilus influenzae and Bacteroides species. (2) UTIs due to E. coli, Klebsiella species, Proteus mirabilis, Morganella morganii, Proteus vulgaris and Providencia species (including P. rettgeri). (3) Uncomplicated gonorrhea due to Neisseria gonorrhoeae (penicillinase/non-penicillinase producing). Intra-abdominal infections (peritonitis and intra-abdominal abscess) due to E. coli, Klebsiella species, Bacteroides species (including B. fragilis), and Clostridium species. (4) Gynecological infections (endometritis, pelvic cellulitis, pelvic inflammatory disease) due to E. coli, N. gonorrhoeae, Bacteroides species (including B. fragilis group), Clostridium species, Peptococcus species, Peptostreptococcus species, and group B streptococci. (5) Septicemia due to S. pneumoniae, S. aureus, E. coli, Klebsiella species, and Bacteroides species (including B. fragilis). (6) Bone and joint infections due to S. aureus. (7) Skin and skin structure infections due to S. aureus, S. epidermidis, streptococci (excluding enterococci, especially S. faecalis), E. coli, P. mirabilis, Klebsiella species, Bacteroides species (including the B. fragilis group), Clostridium species, Peptococcus species, and Peptostreptococcus species. (8) Perioperative prophylaxis, including vaginal hysterectomy, GI surgery, transurethral prostatectomy, prosthetic arthroplasty, and cesarean section.
NOTE: Many gram-negative infections resistant to certain cephalosporins and penicillins respond to cefoxitin.

Additional Side Effects: Higher doses have caused increased incidence of eosinophilia and increased AST levels in children over 3 months of age.

Additional Laboratory Test Interferences: High concentrations may interfere with the measurement of creatinine by the Jaffe method.

How Supplied: Injection: 1 g/50 mL, 2 g/50 mL; Powder for injection: 1 g, 2 g, 10 g

Dosage
•IM, IV Uncomplicated infections (cutaneous, pneumonia, urinary tract).
Adults: 1 g q 6-8 hr IV.
Moderately severe or severe infections.
Adults: 1 g q 4 hr or 2 g q 6-8 hr IV.
Infections requiring higher dosage (e.g., gas gangrene).
Adults: 2 g q 4 hr or 3 g q 6 hr IV.
Gonorrhea.
Adults: 2 g IM with 1 g probenecid PO.
Prophylaxis in surgery.
Adults: 2 g IV 30-60 min before surgery followed by 2 g q 6 hr after first dose for 24 hr only (72 hr for prosthetic arthroplasty).
Cesarean section, prophylaxis.
2 g IV when cord is clamped; then, give two additional doses IV 4 and 8 hr later.
TURP, prophylaxis.
1 g before surgery; then, 1 g q 8 hr for up to 5 days.
Impaired renal function.
Initial: 1-2 g; then, follow maintenance schedule provided by manufacturer. When only creatinine level is available, use the following formulas to obtain C_CR:
Males: Weight (kg) x (140 - age) / 72 x serum creatinine (mg/dL).
Females: 0.85 x above value.
Use in children for infections.
Children over 3 months: 80-160 mg/kg/day in four to six divided doses. Total daily dosage should not exceed 12 g.
Use in children for prophylaxis.
Children over 3 months: 30-40 mg/kg q 6 hr.