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Cefoxitin use while Breastfeeding

Drugs containing Cefoxitin: Mefoxin

Cefoxitin Levels and Effects while Breastfeeding

Summary of Use during Lactation

Cefoxitin is acceptable to use during breastfeeding. Substantial information indicates that maternal doses of cefoxitin up to 4 grams daily produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally, disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush, has been reported with cephalosporins, but these effects have not been adequately evaluated.

Drug Levels

Maternal Levels. After a 1 g dose of cefoxitin in one woman, the cefoxitin level in milk 2 hours after the dose was 5.6 mg/L.[1][2]

Four postpartum women received 1 g of cefoxitin three times a day. Only 8 of 50 breastmilk samples had measurable cefoxitin levels of 0.8 to 1 mg/L. Other samples had unmeasurable (<0.8 mg/L) cefoxitin levels.[3]

Fifteen nursing others received a single intramuscular dose of cefoxitin 1 g. Cefoxitin was not detected (<0.5 mg/L) in any milk samples taken up to 24 hours after the dose.[4]

After a single 2 g intramuscular dose of cefoxitin in 5 women, peak milk levels of 0.31 to 0.65 mg/L occurred 1 to 5 hours after the dose.[5]

Cefoxitin was not measurable in breastmilk at any time up to 6 hours after a single 1 g intravenous dose of cefoxitin in 2 women.[6]

Eighteen women undergoing cesarean section were given either a single 2 g dose of cefoxitin or 2 g followed by two 1 g doses (route unspecified). Cefoxitin was detected (detection limit 0.5 mg/L) in the milk of only one woman at a concentration of 0.9 mg/L 19 hours after the third dose of cefoxitin.[7]

Fifteen women were given a single 1 g dose of cefoxitin intravenously at about 1 month after delivery. The average milk level 2 hours after the dose was 0.05 mg/L.[8]

Five women were who had been receiving intravenous cefoxitin 1 gram twice daily for 2 days following cesarean section each donated a milk sample. The highest milk concentration was 1.71 mg/L at 1 hour after the dose in one woman. Drug concentrations in samples taken at 1.5 or 2 hours after the dose in 3 women ranged from 0.71 to 0.94 mg/L. A fifth woman who donated a milk sample at 2.5 hours after the dose had a milk cefoxitin concentration of 0.57 mg/L.[9]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

References

1. Geddes AM, Schnurr LP, Ball AP et al. Cefoxitin: a hospital study. Br Med J. 1977;1:1126-8. PMID: 861496

2. Geddes AM, McGhie D, Ball AP et al. Studies with cefuroxime and cefoxitin. Scand J Infect Dis. 1978;13 (Suppl):78-81. PMID: 308260

3. Santo GH, Huch A. Ubergang von cefoxitin in muttermilch. Infection. 1979;7(Suppl 1):S90-1.

4. 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. 1981;21:477-83. PMID: 7334140

5. Dresse A, Lambotte R, Dubois M et al. Transmammary passage of cefoxitin: additional results. J Clin Pharmacol. 1983;23:438-40. PMID: 6643697

6. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy. 1984;5:57-60. PMID: 6743732

7. Roex AJM, van Loenen AC, Puyenbroek JI et al. Secretion of cefoxitin in breast milk following short-term prophylactic adminstration in caesarean secretion. Eur J Obstet Gynecol Reprod Biol. 1987;25:299-302. PMID: 3653494

8. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997;32(5):288-92. PMID: 9596854

9. Kiriazopoulos E, Zaharaki S, Vonaparti A et al. Quantification of three beta-lactam antibiotics in breast milk and human plasma by hydrophilic interaction liquid chromatography/positive-ion electrospray ionization mass spectrometry. Drug Test Anal. 2016. PMID: 27714984

Cefoxitin Identification

Substance Name

Cefoxitin

CAS Registry Number

35607-66-0

Drug Class

Antiinfective Agents

Antibacterial Agents

Cephalosporins

Administrative Information

LactMed Record Number

51

Last Revision Date

20161110

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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