KEY POINTS
- Cefoxitin (Mefoxin) is widely mistaken for a second generation cephalosporin, but it is actually a cephamycin.
- Works by inhibiting bacterial cell wall synthesis by binding to one or more penicillin-binding-proteins, which interferes with bacterial cell wall synthesis
- Has activity versus some Gram positive aerobes (including methicillin-sensitive Staphylococcus aureus), some Gram negative aerobes and numerous anaerobic bacteria
- Activity versus Gram negative anaerobe Bacteroides fragilis is variable
- Has activity versus some Mycobacterium abscessus isolates
- May be used for a variety of indications, including gas gangrene, intra-abdominal infections, pelvic inflammatory disease, surgical prophylaxis and more
- Doses range from 1gm every 8 hours to 2gm every 6 hours, usually not exceeding 12gm per day
- Requires adjustment for renal function
- Can be given intravenous or intramuscular
- Beware allergy and gastrointestinal side effects
RESOURCES
- Cefoxitin Package Insert
- IDSA Practice Guidelines
- Clinical Practice Guidelines For Antimicrobial Prophylaxis In Surgery
- ATS/IDSA Non-Tuberculosis mycobacterium Treatment Guidelines