MEFOXIN IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Cefoxitin is a cephamycin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.
| Metabolism | Cefoxitin is not significantly metabolized; primarily excreted unchanged in urine via glomerular filtration and tubular secretion. |
| Excretion | Renal: ~85% unchanged; biliary/fecal: ~15% as active metabolite and unchanged drug. |
| Half-life | Terminal elimination half-life: 0.7–1.1 hours in normal renal function; prolonged to 5–10 hours in severe renal impairment (CrCl <10 mL/min). |
| Protein binding | 73% (primarily albumin). |
| Volume of Distribution | 0.13–0.22 L/kg; indicates distribution mainly into extracellular fluid. |
| Bioavailability | IM: ~100%. |
| Onset of Action | IV: immediate; IM: within 15–30 minutes. |
| Duration of Action | 6–8 hours for susceptible organisms; may require more frequent dosing in severe infections. |
1-2 g IV every 6-8 hours. Maximum 12 g/day.
| Dosage form | INJECTABLE |
| Renal impairment | CrCl 30-50 mL/min: 1-2 g every 8 hours; CrCl 10-29 mL/min: 1-2 g every 12 hours; CrCl <10 mL/min: 1-2 g every 24-48 hours. |
| Liver impairment | No adjustment required for hepatic impairment. |
| Pediatric use | 3 months to 12 years: 80-160 mg/kg/day IV divided every 6-8 hours. Maximum 12 g/day. |
| Geriatric use | Based on renal function; CrCl 30-50 mL/min: 1-2 g every 8 hours; CrCl 10-29 mL/min: 1-2 g every 12 hours; CrCl <10 mL/min: 1-2 g every 24-48 hours. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Cefoxitin is excreted into human breast milk in low concentrations (M/P ratio approximately 0.04-0.3). Likely compatible with breastfeeding due to poor oral bioavailability in infants. Caution with theoretical risk of diarrhea or allergic sensitization. |
| Teratogenic Risk | Cefoxitin is a second-generation cephalosporin classified as FDA Pregnancy Category B. No evidence of teratogenicity in animal studies. Inadequate human data; risk cannot be ruled out. First trimester: unlikely to cause major malformations based on limited data. Second and third trimesters: no documented fetal harm. However, use only if clearly needed. |
■ FDA Black Box Warning
No FDA black box warning.
| Common Effects | fluid replacement |
| Serious Effects |
["Hypersensitivity to cefoxitin or other cephalosporins","Porphyria"]
| Precautions | ["Hypersensitivity reactions including anaphylaxis","Clostridium difficile-associated diarrhea (CDAD)","Prolonged use may result in superinfection","Dose adjustment required in renal impairment","May cause false-positive urine glucose tests with copper reduction methods","Use with caution in patients with history of gastrointestinal disease"] |
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| Fetal Monitoring | Monitor maternal renal function (creatinine, BUN) and liver function tests periodically, especially in prolonged therapy. Monitor for signs of superinfection (oral thrush, vaginal candidiasis) and diarrhea (antibiotic-associated colitis). No specific fetal monitoring required. |
| Fertility Effects | No known adverse effects on fertility in animal studies. Limited human data; no evidence of impaired fertility or reproductive performance. Theoretical risk of alterations in gut flora with prolonged use, but not established. |