Drug Guide

Generic Name

Cefoxitin Sodium

Brand Names Mefoxin, Mefoxin In Sodium Chloride 0.9% In Plastic Container, Mefoxin In Dextrose 5% In Plastic Container, Mefoxin In Plastic Container, Cefoxitin, Cefoxitin And Dextrose In Duplex Container, Cefoxitin In Plastic Container

Classification

Therapeutic: Antibiotic (Cephamycin subclass of beta-lactams)

Pharmacological: Beta-lactam antibacterial

FDA Approved Indications

Treatment of susceptible bacterial infections including intra-abdominal infections, gynecological infections, bone and joint infections, genitourinary tract infections, and respiratory tract infections.

Mechanism of Action

Cefoxitin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell lysis and death.

Dosage and Administration

Adult: Typically 1-2 grams IV every 6-8 hours, adjusted based on infection severity and site.

Pediatric: Dosage varies based on weight and severity; usually 20-40 mg/kg/day divided every 6-8 hours.

Geriatric: Use with caution; monitor renal function and adjust dose accordingly.

Renal Impairment: Adjust dosage based on degree of renal impairment; interval extension may be needed.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Poorly absorbed orally; administered IV or IM.

Distribution: Widely distributed including CSF if meningeal inflammation.

Metabolism: Not extensively metabolized.

Excretion: Primarily renal, with significant renal clearance.

Half Life: Approximately 1 hour.

Contraindications

Known allergy to cephamycins or other beta-lactam antibiotics.

Precautions

Use cautiously in patients with history of hypersensitivity to penicillins, mononucleosis, or colitis.

Adverse Reactions - Common

Di diarrhea (Common)
Nausea (Common)
Injection site reactions (Common)

Adverse Reactions - Serious

Hypersensitivity reactions including anaphylaxis (Rare)
Clostridioides difficile-associated diarrhea (Possible)

Drug-Drug Interactions

Aminoglycosides (synergistic nephrotoxicity)
Probenecid (decreases renal clearance)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of allergy, renal function, and superinfection.

Diagnoses:

Risk for allergic reaction
Impaired renal function

Implementation: Administer IV as prescribed; monitor injection site; assess renal function periodically.

Evaluation: Effectiveness confirmed by resolution of infection; monitor for adverse reactions.

Patient/Family Teaching

Report any allergic reactions immediately.
Complete full course of therapy.
Inform about possible gastrointestinal side effects.

Special Considerations

Black Box Warnings:

None specifically, but caution in patients with severe hypersensitivity to beta-lactams.

Genetic Factors: Potential for hypersensitivity in individuals with penicillin allergy.

Lab Test Interference: May interfere with urine glucose testing using some dipsticks, causing false positives.

Overdose Management

Signs/Symptoms: Gastrointestinal disturbances, convulsions in severe cases.

Treatment: Supportive; dialysis may be used in severe renal failure cases.

Storage and Handling

Storage: Store at 20-25°C (68-77°F), protected from light.

Stability: Stable for the period specified in the manufacturer's instructions when stored properly.