cefoxitin

Action and Spectrum

Actions and Spectrum: 

• cefoxitin is a second-generation cephalosporin antibiotic that belongs to the beta-lactam class. It works by inhibiting bacterial cell wall synthesis by binding to and inactivating penicillin-binding proteins (PBPs), enzymes in the final stages of bacterial cell wall synthesis. This leads to the weakening of the cell wall, ultimately resulting in bacterial cell death. 
• cefoxitin has a broad spectrum of activity against various gram-positive and gram-negative bacteria, including anaerobes. It is effective against many common pathogens, including Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Staphylococcus aureus, Streptococcus pneumoniae, and Bacteroides fragilis. It is commonly used to treat respiratory and urinary tract infections, skin and soft tissue, and intra-abdominal infections. cefoxitin is ineffective against methicillin-resistant Staphylococcus aureus (MRSA) or Enterococcus species. 

Drug Interaction

Adverse Reaction

Frequency defined 

>10% 

Diarrhea 

<1% 

Eosinophilia 

Thrombocytopenia 

Elevated LFT’s 

Anemia 

Transient leukopenia 

SCr & BUN increased 

Black Box Warning

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Known allergy or hypersensitivity to cephalosporin antibiotics or any of the components of cefoxitin. 
• History of severe allergic reactions (such as anaphylaxis) to penicillin or other beta-lactam antibiotics. 
• History of gastrointestinal disease, particularly colitis or inflammatory bowel disease, as cefoxitin can exacerbate these conditions. 
• Pre-existing kidney disease or impairment, such as cefoxitin, can cause further renal damage in patients with kidney disease. 
• Pregnancy or breastfeeding, as the safety of cefoxitin in these situations, has not been established. 

Caution: 

• Diarrhea: cefoxitin can disrupt the natural balance of bacteria in the digestive tract, leading to diarrhea. 
• Superinfection: cefoxitin can cause a secondary infection by promoting the growth of antibiotic-resistant bacteria or fungi. If you develop symptoms of a new infection (such as fever, sore throat, or skin rash) while taking cefoxitin, contact your healthcare provider. 
• Bleeding disorders: cefoxitin can interfere with blood clotting, so it should be used cautiously in patients with bleeding disorders or those taking anticoagulant medications. 
• Seizure disorders: cefoxitin can lower the seizure threshold and cause seizures in patients with a history of seizure disorders or those at risk for seizures. 
• Liver disease: cefoxitin can cause liver damage or worsen existing liver disease in some patients. 

Pregnancy / Lactation

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

cefoxitin is a second-generation cephalosporin antibiotic that belongs to the beta-lactam class. It works by inhibiting bacterial cell wall synthesis by binding to and inactivating penicillin-binding proteins (PBPs), enzymes in the final stages of bacterial cell wall synthesis. This leads to the weakening of the cell wall, ultimately resulting in bacterial cell death. 

Pharmacodynamics: 

• The pharmacodynamics of cefoxitin involves its ability to inhibit bacterial cell wall synthesis by binding to and inactivating penicillin-binding proteins (PBPs), which are enzymes involved in the final stages of bacterial cell wall synthesis. This leads to the weakening of the cell wall, ultimately resulting in bacterial cell death. 
• The effectiveness of cefoxitin depends on its concentration in the body relative to the targeted bacteria’s minimum inhibitory concentration (MIC). The MIC is the lowest concentration of an antibiotic required to inhibit the growth of a specific microorganism. 

Pharmacokinetics: 

Absorption 

cefoxitin is an injectable medication rapidly absorbed after intramuscular or intravenous administration. It is not absorbed orally. 

Distribution 

cefoxitin is distributed widely throughout the body, with high concentrations in bile, liver, kidney, lung, and bone. It can also cross the placenta and is excreted into breast milk. 

Metabolism 

cefoxitin is metabolized in the liver by hydrolysis of the beta-lactam ring to form an inactive metabolite. There are no active metabolites of cefoxitin. 

Elimination and excretion 

cefoxitin is excreted primarily by the kidneys, with approximately 80% of the dose excreted unchanged in the urine within 6-8 hours. The remaining 20% is excreted in the bile and feces 

Adminstartion

Administration: 

• cefoxitin is available as an injectable medication and is administered intravenously or intramuscularly. The recommended dosage, route of administration, and duration of treatment may vary depending on the type and severity of the infection being treated, as well as the age, weight, and renal function of the patient. 
• For most infections, the usual adult dose of cefoxitin is 1-2 grams every 6-8 hours, either by intravenous infusion over 30 minutes or intramuscular injection. In severe infections, the dose may be increased to 12 grams per day, divided into four to six equal doses. The usual paediatric dose is 80-160 mg/kg/day, divided into four to six equal doses 

Patient Information Leaflet

Patient information leaflet 

Generic Name: cefoxitin 

Pronounced: [ sef-OX-i-tin] 

Why do we use cefoxitin? 

cefoxitin is a broad-spectrum antibiotic that is used to treat a variety of bacterial infections. Some of the common uses of cefoxitin include: 

• Intra-abdominal infections: cefoxitin is often used to treat intra-abdominal infections, including peritonitis, diverticulitis, and appendicitis. 
• Obstetric and gynecologic infections: cefoxitin may be used to treat infections in the female reproductive system, such as pelvic inflammatory disease, endometritis, and postpartum infections. 
• Skin and soft tissue infections: cefoxitin may be used to treat bacterial infections of the skin and soft tissues, such as cellulitis, abscesses, and wound infections. 
• Respiratory tract infections: cefoxitin may be used to treat respiratory tract infections, such as pneumonia and bronchitis. 
• Bone and joint infections: cefoxitin may be used to treat bone and joint infections, such as osteomyelitis and septic arthritis. 
• Urinary tract infections: cefoxitin may be used to treat urinary tract infections, including pyelonephritis and cystitis.