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
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.
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
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.
References
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