Comparative Pharmacology
Head-to-head clinical analysis: CEFOXITIN versus CEPHALOTHIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CEFOXITIN versus CEPHALOTHIN.
CEFOXITIN vs CEPHALOTHIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Cefoxitin is a cephamycin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), particularly PBP-1 and PBP-3, thereby inhibiting the final transpeptidation step of peptidoglycan synthesis. This leads to cell lysis and death. It is resistant to beta-lactamases produced by many Gram-negative and Gram-positive bacteria.
Cephalothin is a first-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), thereby blocking peptidoglycan cross-linking. It has activity against gram-positive cocci (e.g., Staphylococcus aureus, Streptococcus pyogenes) and some gram-negative bacilli (e.g., Escherichia coli, Klebsiella pneumoniae).
1-2 g IV every 6-8 hours; maximum 12 g/day.
1-2 g IV every 4-6 hours; maximum 12 g/day.
None Documented
None Documented
Clinical Note
moderateCefoxitin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Cefoxitin."
Clinical Note
moderateCefoxitin + Picosulfuric acid
"The therapeutic efficacy of Picosulfuric acid can be decreased when used in combination with Cefoxitin."
Clinical Note
moderateWarfarin + Cefoxitin
"Warfarin may increase the anticoagulant activities of Cefoxitin."
Clinical Note
moderatePhenprocoumon + Cefoxitin
Terminal elimination half-life is approximately 0.7–1.1 hours (mean 0.8 h) in adults with normal renal function, extending to 5–10 hours in severe renal impairment (CrCl <10 mL/min).
0.5-1 hour in patients with normal renal function; prolonged to 2-8 hours in moderate renal impairment (CrCl 30-50 mL/min); up to 20-30 hours in end-stage renal disease; due to rapid elimination, frequent dosing (q4-6h) is required for continuous bactericidal levels.
Renal excretion of unchanged drug accounts for approximately 85% of elimination; biliary excretion is minimal (<1%); fecal elimination is negligible.
Primarily renal (60-90% unchanged) via tubular secretion and glomerular filtration; minor biliary excretion (less than 5%); hepatic metabolism to desacetylcephalothin (active but less potent) accounts for about 20-30% of dose; fecal elimination negligible.
Category A/B
Category C
Cephalosporin Antibiotic
Cephalosporin Antibiotic
"Phenprocoumon may increase the anticoagulant activities of Cefoxitin."