Cefoxitin Side Effects

Brand Names: Mefoxin

Please note - some side effects for Cefoxitin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Cefoxitin - for the Consumer

Cefoxitin

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Cefoxitin:

Diarrhea; nausea; vomiting.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; decreased urination; dizziness; fever; hoarseness; pain, swelling, or redness at the injection site; red, swollen, or blistered skin; seizures; severe diarrhea; severe nausea or vomiting; stomach pain or cramping; unusual bruising or bleeding; unusual tiredness; vaginal irritation or discharge; vein inflammation; white patches in mouth; yellowing of the eyes and skin.

Cefoxitin Side Effects - for the Professional

Cefoxitin

Cefoxitin is generally well tolerated. The most common adverse reactions have been local reactions following intravenous injection. Other adverse reactions have been encountered infrequently.

Local Reactions

Thrombophlebitis has occurred with intravenous administration.

Allergic Reactions

Rash (including exfoliative dermatitis and toxic epidermal necrolysis), urticaria, flushing, pruritus, eosinophilia, fever, dyspnea, and other allergic reactions including anaphylaxis, interstitial nephritis and angioedema have been noted.

Cardiovascular

Hypotension.

Gastrointestinal

Diarrhea, including documented pseudomembranous colitis which can appear during or after antibiotic treatment. Nausea and vomiting have been reported rarely.

Neuromuscular

Possible exacerbation of myasthenia gravis.

Blood

Eosinophilia, leukopenia including granulocytopenia, neutropenia, anemia, including hemolytic anemia, thrombocytopenia, and bone marrow depression. A positive direct Coombs test may develop in some individuals, especially those with azotemia.

Liver Function

Transient elevation in SGOT, SGPT, serum LDH, and serum alkaline phosphatase; and jaundice have been reported.

Renal Function

Elevations in serum creatinine and/or blood urea nitrogen levels have been observed. As with the cephalosporins, acute renal failure has been reported rarely. The role of Cefoxitin in changes in renal function tests is difficult to assess, since factors predisposing to prerenal azotemia or to impaired renal function usually have been present.

In addition to the adverse reactions listed above which have been observed in patients treated with Cefoxitin, the following adverse reactions and altered laboratory test results have been reported for cephalosporin class antibiotics:

Urticaria, erythema multiforme, Stevens-Johnson syndrome, serum sickness-like reactions, abdominal pain, colitis, renal dysfunction, toxic nephropathy, false-positive test for urinary glucose, hepatic dysfunction including cholestasis, elevated bilirubin, aplastic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, agranulocytosis, superinfection, vaginitis including vaginal candidiasis.

Several cephalosporins have been implicated in triggering seizures, particularly in patients with renal impairment when the dosage was not reduced. If seizures associated with drug therapy occur, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated.

Side Effects by Body System

General

Cefoxitin is generally well-tolerated.

Hypersensitivity

Hypersensitivity reactions have included pruritus, rash, exfoliative dermatitis, toxic epidermal necrolysis, urticaria, flushing, dyspnea, angioedema, anaphylaxis, interstitial nephritis, eosinophilia, and fever. Cephalosporin class antibiotics have been associated with erythema multiforme, Stevens-Johnson syndrome, and serum sickness-like reactions.

There is a 10% to 20% chance of an allergic reaction to cefoxitin (or any cephalosporin) among patients who are allergic to a penicillin.

A case of occupational contact dermatitis due to cephalosporin allergy has been reported in a nurse who prepared cephalosporin solutions for administration to patients. The dermatitis resolved after the nurse stopped preparing the solutions.

Gastrointestinal

A 60-year-old man with bilateral staghorn renal calculi, Proteus mirabilis urinary tract infection, and acute renal failure developed non-bloody diarrhea and fever associated with leukocytosis and ileus within two days after beginning cefoxitin 1 gram intravenously once a day. Sigmoidoscopy and stool pathology revealed innumerable small white plaques and Clostridium difficile toxin. The cefoxitin was stopped, vancomycin retention enemas were given (due to ileus, oral vancomycin was not tried), and the patient recovered.

A study of 374 patients demonstrated that of 21 patients developing Clostridium difficile colitis, 17.9% had received cefoxitin.

Pseudomembranous colitis may occur during or after treatment.

Gastrointestinal side effects have included nausea, vomiting, diarrhea, and pseudomembranous colitis. Cephalosporin class antibiotics have been associated with abdominal pain and colitis.

Nervous system

Nervous system side effects have included somnolence, dizziness, and headache. Some cephalosporin-class antibiotics have been associated with seizures, especially in patients with renal dysfunction.

Renal

Renal side effects have included increased serum creatinine and blood urea nitrogen, and acute renal failure (rare). Cephalosporin class antibiotics have been associated with renal dysfunction, toxic nephropathy, reversible, dose-related acute tubular necrosis, and interstitial nephritis. Interstitial nephritis manifests as reversible fever, azotemia, pyuria, and eosinophiluria.

Local

Local side effects have included thrombophlebitis with intravenous administration.

Cardiovascular

Cardiovascular side effects have included hypotension.

Musculoskeletal

Musculoskeletal side effects have included exacerbation of myasthenia gravis.

Hematologic

Hematologic side effects have included eosinophilia, leukopenia, granulocytopenia, neutropenia, anemia, hemolytic anemia, thrombocytopenia, bone marrow depression, and positive direct Coombs' test. Cephalosporin class antibiotics have been associated with aplastic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, and agranulocytosis.

Hepatic

Hepatic side effects have included transient elevations of SGOT, SGPT, LDH, and alkaline phosphatase, and jaundice. Cephalosporin class antibiotics have been associated with hepatic dysfunction, cholestasis, and elevated bilirubin.

Genitourinary

Genitourinary side effects associated with cephalosporin class antibiotics have included vaginitis, vaginal candidiasis, and false positive tests for urine glucose.

Other

Other side effects associated with cephalosporin class antibiotics have included superinfection.

Other

Other side effects associated with higher doses of cefoxitin have included an increased incidence of SGOT elevations and eosinophilia in pediatric patients.

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