Cefoxitin injection
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Powder for solution for injection containing cefoxitin.
Drugs List
Therapeutic Indications
Uses
Complicated urinary tract infections
Pyelonephritis
Cefoxitin is indicated for the treatment of complicated urinary tract infections and pyelonephritis, in infections known to be caused by pathogens susceptible to cefoxitin and for which other, more commonly prescribed antibacterial agents are not appropriate.
Dosage
Adults
2g every 4 to 6 hours, maximum dose of 12g per day.
Children
Children aged 11 to 18 years old
2g every 4 to 6 hours, maximum dose of 12g per day.
Patients with Renal Impairment
Creatinine clearance 30 to 50ml/minute: initial dose of 2g, followed by maintenance dose of 2g every 8 to 12 hours.
Creatinine clearance 10 to 29ml/minute: initial dose of 2g, followed by maintenance dose of 2g every 12 to 24 hours.
In patients receiving haemodialysis, the initial dose of 2g should be given after haemodialysis.
Contraindications
Children under 11 years
Breastfeeding
Precautions and Warnings
Pregnancy
Renal impairment
Haemodialysis patients: administer drug after dialysis
Advise patient ability to drive or operate machinery may be impaired
Before initiating therapy enquire about previous hypersensitivity reactions
Treatment to be initiated and supervised by a specialist
Monitor urine of diabetic patients for ketones
Consider pseudomembranous colitis if patient presents with diarrhoea
Prolonged use may result in superinfection with non-susceptible organisms
May affect results of some laboratory tests
Discontinue at once if pseudomembranous colitis occurs
Discontinue if hypersensitivity reactions occur
Antibiotic-associated colitis have been reported with anti-bacterial agents and may occur with cefoxitin use. Consider colitis in patients present with diarrhoea during or subsequent to cefoxitin administration. If such symptoms occur, consider discontinuation of treatment and consider use of other supportive measures. Medicinal products that inhibit peristalsis should not be used.
The use of beta-lactam antibiotics increases the risk of encephalopathy. Cefoxitin may have major influence on the ability to drive and use machines due to the increased risk of the occurrence of encephalopathy.
Pregnancy and Lactation
Pregnancy
Use cefoxitin with caution during pregnancy.
The manufacturer recommends that cefoxitin should only be used during pregnancy if clinically needed.
At the time of writing there is limited published information regarding the use of cefoxitin during pregnancy. Potential risks are unknown. Animal studies have not shown evidence of teratogenic effects.
Lactation
Cefoxitin is contraindication during breastfeeding.
The manufacturer recommends that cefoxitin should be discontinued during breastfeeding to prevent hypersensitivity reactions in the infant.
Cefoxitin is known to be excreted in milk.
Side Effects
Altered consciousness
Anaemia
Anaphylactic reaction
Angioedema
Bone marrow failure
Confusion
Diarrhoea
Encephalopathy
Eosinophilia
Exacerbation of myasthenia gravis
Increase in alkaline phosphatase
Increase in blood urea nitrogen
Increase in lactate dehydrogenase
Increase in serum transaminases
Interstitial nephritis
Leukopenia
Local reaction at injection site
Movement disturbances
Nausea
Neutropenia
Pruritus
Pseudomembranous colitis
Pyrexia
Rash
Renal impairment
Seizures
Serum creatinine increased
Thrombocytopenia
Thrombophlebitis (localised)
Toxic epidermal necrolysis
Urticaria
Vomiting
Effects on Laboratory Tests
Coombs tests:
False-positive coombs test results have been observed in treatment with cephalosporins, this may occur with cefoxitin treatment.
Glucose in the urine:
A false-positive reaction may occur with reducing substances but not with specific glucose oxidase methods
Serum creatinine levels:
Levels should not be taken within two hours of drug administration.
Using the Jaffe method, falsely high serum creatinine levels may occur if cefoxitin serum concentrations are greater than 100 micrograms / ml
Corticosteroids:
Porter-Silber method of measuring 17-hydroxy-corticosteroids may give slightly falsely increased results if there is high concentration of cefoxitin in the urine.
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: September 2019
Reference Sources
Summary of Product Characteristics: Renoxitin 2g Powder for solution for injection or infusion. Revised: April 2019.
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.