Cefoxitin Side Effects

Some side effects of cefoxitin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to cefoxitin: injectable powder for injection, intravenous solution

Get emergency medical help if you have any of these signs of an allergic reaction while taking cefoxitin: 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.

For Healthcare Professionals

Applies to cefoxitin: injectable powder for injection, intravenous solution

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

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

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.

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 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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