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cefoxitin

Pronunciation

Generic Name: cefoxitin (sef OX i tin)
Brand Name: Mefoxin

What is cefoxitin injection?

Cefoxitin is in a group of drugs called cephalosporin (SEF a low spor in) antibiotics. It works by fighting bacteria in your body.

Cefoxitin is used to treat many kinds of bacterial infections, including severe or life-threatening forms.

Cefoxitin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about cefoxitin?

Do not use this medication if you are allergic to cefoxitin, or to similar antibiotics, such as Ceftin, Cefzil, Keflex, Omnicef, and others.

Before using this medication, tell your doctor if you are allergic to any drugs (especially penicillin). Also tell your doctor if you have liver or kidney disease, diabetes, heart failure, cancer, a stomach or intestinal disorder, or if you are malnourished.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Cefoxitin will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

This medication can cause you to have unusual results with certain lab tests, including tests to check for glucose (sugar) in the urine. Tell any doctor who treats you that you are using cefoxitin.

What should I discuss with my health care provider before using cefoxitin injection?

Do not use this medication if you are allergic to cefoxitin, or to other cephalosporin antibiotics, such as:

  • cefaclor (Raniclor);

  • cefadroxil (Duricef);

  • cefazolin (Ancef);

  • cefdinir (Omnicef);

  • cefditoren (Spectracef);

  • cefpodoxime (Vantin);

  • cefprozil (Cefzil);

  • ceftibuten (Cedax);

  • cefuroxime (Ceftin);

  • cephalexin (Keflex);

  • cephradine (Velosef); and others.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take cefoxitin:

  • kidney disease;

  • liver disease;

  • a stomach or intestinal disorder such as colitis;

  • diabetes;

  • congestive heart failure;

  • cancer;

  • if you are malnourished; or

  • if you have had a very recent surgery or medical emergency.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Cefoxitin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is cefoxitin given?

Cefoxitin is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. You may be given instructions on how to inject your medicine at home. Do not use this medicine at home if you do not fully understand how to give the injection and properly dispose of needles and other items used in giving the medicine.

Use the medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Use this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Cefoxitin will not treat a viral infection such as the common cold or flu.

This medication can cause you to have unusual results with certain lab tests, including tests to check for glucose (sugar) in the urine. Tell any doctor who treats you that you are using cefoxitin.

To be sure this medication is helping your condition, your blood may need to be tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you keep this medicine at home, store it in a deep freezer at a temperature of 4 degrees below 0.

To use the medicine, thaw it in a refrigerator or at room temperature. Do not warm in a microwave or boiling water. Keep thawed medicine in the refrigerator and use it within 28 days after thawing it. Do not refreeze.

Do not use the medication if it looks cloudy or has any particles in it. Call your doctor for a new prescription.

What happens if I miss a dose?

Use the medication as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a cefoxitin overdose may include seizure (convulsions).

What should I avoid while using cefoxitin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Cefoxitin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • diarrhea that is watery or bloody;

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • swelling, pain, or irritation where the injection was given;

  • skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

  • feeling light-headed, fainting;

  • easy bruising or bleeding, unusual weakness;

  • fever, chills, body aches, flu symptoms;

  • urinating less than usual or not at all;

  • seizure (black-out or convulsions); or

  • jaundice (yellowing of the eyes or skin).

Less serious side effects are more likely to occur, such as:

  • nausea, vomiting, stomach pain;

  • mild skin rash; or

  • vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Cefoxitin dosing information

Usual Adult Dose for Aspiration Pneumonia:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Intraabdominal Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Joint Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Osteomyelitis:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Peritonitis:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Pneumonia:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Bacterial Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Urinary Tract Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Skin and Structure Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Endometritis:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
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

Usual Adult Dose for Pelvic Inflammatory Disease:

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

Centers for Disease Control and Prevention (CDC) recommendations:
Mild-to-moderately severe infections:
When parenteral regimen is used: 2 g IV every 6 hours plus oral or IV doxycycline
Parenteral therapy should be continued for at least 24 hours after clinical improvement is demonstrated. Oral therapy with doxycycline should then be continued to complete 14 days of treatment.

When oral regimen is used: 2 g IM as a single dose with probenecid 1 g orally as a single dose plus oral doxycycline (with or without oral metronidazole) for 14 days

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Septicemia:

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

Usual Adult Dose for Cesarean Section:

1 to 2 g IV as soon as the umbilical cord is clamped and may be followed by 1 to 2 g IV 4 and 8 hours after the initial dose

Usual Adult Dose for Surgical Prophylaxis:

For prophylactic use in uncontaminated gastrointestinal surgery, vaginal hysterectomy, or abdominal hysterectomy: 1 to 2 g IV 30 to 60 minutes prior to surgery followed by 1 to 2 g IV every 6 hours after the first dose for no more than 24 hours

Usual Adult Dose for Gonococcal Infection -- Uncomplicated:

(Not approved by FDA)

CDC recommendations:
Uncomplicated infections of the cervix, urethra, or rectum: 2 g IM as a single dose with probenecid 1 g orally as a single dose

This regimen with probenecid is recommended if ceftriaxone is not an option.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Usual Pediatric Dose for Intraabdominal Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Joint Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Osteomyelitis:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Peritonitis:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Pneumonia:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Septicemia:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Bacterial Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Urinary Tract Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Skin and Structure Infection:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Endometritis:

Lower respiratory tract infections (including pneumonia and lung abscess), urinary tract infections, intraabdominal infections (including peritonitis and intraabdominal abscess), gynecological infections (including endometritis, pelvic cellulitis, and pelvic inflammatory disease), septicemia, bone and joint infections, and skin and skin structure infections:
3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

Usual Pediatric Dose for Pelvic Inflammatory Disease:

3 months or older: 80 to 160 mg/kg/day IV divided in 4 to 6 equal doses
Maximum dose: 12 g/day

CDC recommendations for adolescents:
Mild-to-moderately severe infections:
When parenteral regimen is used: 2 g IV every 6 hours plus oral or IV doxycycline

Parenteral therapy should be continued for at least 24 hours after clinical improvement is demonstrated. Oral therapy with doxycycline should then be continued to complete 14 days of treatment.

When oral regimen is used: 2 g IM as a single dose with probenecid 1 g orally as a single dose plus oral doxycycline (with or without oral metronidazole) for 14 days

The patient's sexual partner(s) should also be evaluated/treated.

Usual Pediatric Dose for Surgical Prophylaxis:

For prophylactic use in uncontaminated gastrointestinal surgery, vaginal hysterectomy, or abdominal hysterectomy:
3 months or older: 30 to 40 mg/kg/dose IV 30 to 60 minutes prior to surgery followed by 30 to 40 mg/kg/dose IV every 6 hours after the first dose for no more than 24 hours
Maximum dose: 2 g/dose

Usual Pediatric Dose for Cesarean Section:

1 to 2 g IV as soon as the umbilical cord is clamped and may be followed by 1 to 2 g IV 4 and 8 hours after the initial dose

Usual Pediatric Dose for Gonococcal Infection -- Uncomplicated:

(Not approved by FDA)

CDC recommendations:
Uncomplicated infections of the cervix, urethra, or rectum in adolescents: 2 g IM once with probenecid 1 g orally once

This regimen with probenecid is recommended if ceftriaxone is not an option.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

What other drugs will affect cefoxitin?

Before using cefoxitin, tell your doctor if you are using any of the following drugs:

  • an antibiotic such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Mycifradin, Neo-Fradin, Neo-Tab), netilmicin (Netromycin), streptomycin, or tobramycin (Nebcin, Tobi).

This list is not complete and there may be other drugs that can interact with cefoxitin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist has information about cefoxitin written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2010-12-15, 5:01:39 PM.

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