Cefoxitin

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