Cefoxitin (Mefoxin)

Category:

  • Antibiotic

Description:

  • Cephalosporin, Second Generation

Indications:

  • Lower respiratory tract infections (S. pneumoniae, other streptococcus species, S. aureus, E. coli, Klebsiella species, H. influenzae, Bacteriodes  species)

  • Urinary tract infections (E. coli, Klebsiella species, indole-positive Proteus species (including P. vulgaris, Morganella morgani ), P. miribalis, Providencia rettgeri, N. gonorrhoeae)

  • Gynecological infections (E. coli, N. gonorrhoeae, Bacteriodes  species, Clostridium species, Peptococcus and Peptostreptococcus species and group B streptococci)

  • Intra-abdominal infections (E. coli, Klebsiella species, Bacteriodes  species, Clostridium species)

  • Skin, bone and joint infections (S. aureus, S. epidermidis, streptococcus species, E. coli, P. miribalis, Klebsiella species, Bacteriodes  species, Clostridium species, Peptococcus and Peptostreptococcus species)

  • Septicemia (S. pneumoniae, S. aureus, E. coli, Klebsiella species, Bacteriodes  species)

Contraindications:

  • Cross sensitivity with penicillin allergies

Precautions:

  • Pregnancy category B

  • Use with caution in patients with penicillin allergy (5-10% chance of cross-reactivity)

  • Dosage modifications are generally only required in patients with severe renal impairment

Adverse Reactions (Side Effects):

  • Hypersensitivity reactions

  • Gastrointestinal: nausea, vomiting, diarrhea

  • Vaginitis  

Dosage:

  • Administered by IM or IV injection

  • Adults:

    • 1-2 grams every 6-8 hours IM or IV for 5-10 days

  • Child:

    • 80-160mg/kg/day in divided does every 4-6 hours

  • Uncomplicated infections:

    • 3-4 grams per day (1 gram q6-8h IV)

  • Moderate to severe infections:

    • 6-8 grams per day (1 gram q4h IV or 2 grams q6-8h IV)

  • Infections generally requiring high dosages (gas gangrene):

    • 12 grams per day (2 grams q4h IV or 3 grams q6h IV)

  • Uncomplicated gonorrhea: 

    • 2g IM with 1 gram oral probenecid given concurrently

  • Perioperative prophylaxis:

    • Pre-op: 2 grams IV, 30 to 60 minutes pre-surgery

    • Post-op: 2 grams q6h IV for less than 24 hours

  • Cesarean section prophylaxis:

    • 2 gram IN as soon as umbilical cord is clamped

    • if three dose regimen: 2d and 3rd doses of 2 grams IV given 4 & 8 hours after first dose

  • Transurethral prostatectomy prophylaxis:

    • 1 gram IV pre-op and 1 gram q8h IV for less than 5 days

 
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