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Cefoxitin Pregnancy and Breastfeeding Warnings

Cefoxitin is also known as: Mefoxin

Cefoxitin Pregnancy Warnings

There are no reports of adverse side effects due to cefoxitin during human pregnancy. Data from its use immediately prior to abortion reveal that it crosses the placenta. In one case, a woman who was given cefoxitin 1 gram intravenously produced maternal and fetal serum levels of zero and 35.7 mcg per mL 4.25 hours after administration; in another case these levels were 10.5 mcg per mL and zero at 0.9 hours after administration. Data from the use of cefoxitin at term after doses of 1 or 2 gram intravenously or intramuscularly reveal umbilical cord levels up to 22 mcg per mL (11% to 90% of the maternal serum levels).

Cefoxitin has been assigned to pregnancy category B by the FDA. Animal studies failed to reveal evidence of teratogenicity. There are no controlled data in human pregnancy. Cefoxitin should only be given during pregnancy when need has been clearly established.

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Cefoxitin Breastfeeding Warnings

Cefoxitin is excreted into human milk in small amounts. Adverse effects in the nursing infant are unlikely. Cefoxitin is considered compatible with breast-feeding by the American Academy of Pediatrics. The manufacturer recommends that caution be used when administering cefoxitin to nursing women.

Approximately 25 hours after a single, prophylactic dose of cefoxitin 2 to 4 grams intravenously was given to 18 women, only one sample in one patient at 19 hours post-dosing revealed detectable cefoxitin levels in milk (0.9 mcg per mL). This represents a miniscule dose to the nursing infant. Some experts, however, warn of the possibility of modification of neonatal gut flora, unknown direct side effects on the nursing infant, and interference with the interpretation of culture results in the evaluation of a suspected infection.

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References for pregnancy information

  1. Brogden RN, Heel RC, Speight TM, Avery GS "Cefoxitin: a review of its antibacterial activity, pharmacological properties and therapeutic use." Drugs 17 (1979): 1-2,5-6,17-20,28-37
  2. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
  3. "Product Information. Mefoxin (cefoxitin)." Merck & Co, Inc, West Point, PA.

References for breastfeeding information

  1. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
  2. Dubois M, Delapierre D, Chanteux L, et al "A study of the transplacental transfer and the mammary excretion of cefoxitin in humans." J Clin Pharmacol 21 (1981): 477-83
  3. Dresse A, Lambotte R, Dubois M, et al "Transmammary passage of cefoxitin: additional results." J Clin Pharmacol 23 (1983): 438-40
  4. Roberts RJ, Blumer JL, Gorman RL, et al "American Academy of Pediatrics Committee on Drugs: Transfer of drugs and other chemicals into human milk." Pediatrics 84 (1989): 924-36
  5. "Product Information. Mefoxin (cefoxitin)." Merck & Co, Inc, West Point, PA.
  6. Roex AJ, van Loenen AC, Puyenbroek JI, Arts NF "Secretion of cefoxitin in breast milk following short-term prophylactic administration in caesarean section." Eur J Obstet Gynecol Reprod Biol 25 (1987): 299-302

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