Cefoxitin

MEFOXIN

Open Cefoxitin in the interactive console ↗

Pronunciation: sef-OX-i-tin

Cefoxitin ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Cefoxitin ballicule

What it isPBP-inhibiting cephamycin with anaerobic activity; abdominal and pelvic infection, and colorectal prophylaxis.

Why this oneIt covers anaerobes, which the true second-generation cephalosporins do not.

What limits itIt induces AmpC beta-lactamases, so resistance emerges on therapy. Short half-life; frequent dosing.

Cefoxitin molecular structure (skeletal formula) — Molecular structure: Cefoxitin

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
General treatment (usual range)	Adults	1–2 g q6–8h IV	1–2 g q6–8h	12 g/day
Uncomplicated infections	Adults	1 g q6–8h IV	1 g q6–8h	12 g/day
Moderately severe/severe infections	Adults	1 g q4h or 2 g q6–8h IV	1 g q4h or 2 g q6–8h	12 g/day
Higher-dose infections (e.g. gas gangrene)	Adults	2 g q4h or 3 g q6h IV	2 g q4h or 3 g q6h	12 g/day
Perioperative prophylaxis	Adults	2 g IV pre-op, then 2 g q6h ×≤24 h
General treatment	Children ≥3 mo	80–160 mg/kg/day divided into 4–6 doses	80–160 mg/kg/day divided 4–6×	12 g/day
Perioperative prophylaxis	Children ≥3 mo	30–40 mg/kg/dose at designated times	30–40 mg/kg/dose

Renal After 1–2 g loading dose: 1–2 g q8–12h (CrCl 30–50), 1–2 g q12–24h (10–29), 0.5–1 g q12–24h (5–9), 0.5–1 g q24–48h (<5). Hemodialysis: loading dose after each session

Hepatic Undefined

Instructions

IV administration after reconstitution
Do not add to aminoglycoside solutions — administer separately
GABHS infection: treat ≥10 days; max 12 g/day

Available strengths

inj 1, 2 g

Cautions

Hypersensitivity/anaphylaxis; cross-reactivity in penicillin-allergic patients
Pseudomembranous colitis
Possible exacerbation of myasthenia gravis
Seizures reported with cephalosporins in renal impairment
Positive Coombs (especially with azotemia)

Adverse reactions

Local: thrombophlebitis
Allergic: rash, urticaria, pruritus, eosinophilia, fever, anaphylaxis
Diarrhea/pseudomembranous colitis, nausea, vomiting
Blood: eosinophilia, leukopenia/neutropenia, anemia, thrombocytopenia
Transient AST/ALT/LDH/ALP elevations; increased creatinine/BUN

Pregnancy No teratogenic/fetal-toxic effects in rats/mice (slight fetal weight decrease); rabbit abortion/maternal death; use only if clearly needed

Lactation Undefined

Cost

Cefoxitin (MEFOXIN)

Strength		#/mo	generic $/unit	CostPlus
1 g	inj	per unit		not offered
2 g	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Cefoxitin is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry1987

NO BOXED WARNINGS

Principal riskIt induces AmpC beta-lactamases, so resistance emerges on therapy

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryB

Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.

Open Cefoxitin in the interactive console ↗