Adult Dosing
Most Bacterial infections
- 1-2 g IV q6-8 hrs
- Max: 12 g/day
Severe infections
- 1 g IV q4 hrs or 2 g q6-8 hrs
Life-threatening infections
- 2 g IV q4 hrs or 3 g q6 hrs
Surgical prophylaxis
- 2 g IV 30-60 mins before surgery, then 2 g IV q6 hrs for up to 24 hrs
Pediatric Dosing
Bacterial infections
Child > 3 months
- 80-160 mg/kg/day IV divided q4-6 hrs
- Max: 12 g/day
Surgical prophylaxis
Child > 3 months
- 30-40 mg/kg IV 30-60 mins before surgery, then 30-40 mg/kg g IV q6 hrs for up to 24 hrs
Renal Dose Adjustment (Based on CrCl)
- 30-50 mL/min: 1-2 g loading dose followed by 1-2 g q8-12 hrs
- 10-29 mL/min: 1-2 g loading dose followed by 1-2 g q12-24 hrs
- 5-9 mL/min: 1-2 g loading dose followed by 0.5-1 g q12-24 hrs
- <5 mL/min: 1-2 g loading dose followed by 0.5-1 g 24-48 hrs
- HD: 1-2 g supplement after each dialysis period folowed by maintenance dose based on CrCl
- PD: 1g q24 hrs
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Before starting therapy with cefoxitin, carefully inquire if patients have had previous hypersensitivity to cephalosporins, penicillins or other b-lactams. Extreme caution must be exercised as cross reactivity among beta-lactam antibiotics is clearly documented and may occur in up to 10% of patients
- If an allergic reaction occurs, discontinue use and institute appropriate therapeutic measures
- Reduce total daily dose when Cefoxitin is administered to patients with transient or persistent reduction of urinary output due to renal insufficiency
- Cefoxitin should be used to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. Prescribing in the absence of a proven or strongly suspected bacterial infection increases the risk of the development of drug-resistant bacteria
- Obtain culture and susceptibility studies before starting therapy to determine the susceptibility of the causative organisms to cefoxitin
- Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of cephalosporins
- Prolonged use may result in the overgrowth of nonsusceptible organisms
Cautions: Use cautiously in
- Renal impairment
- Concurrent nephrotoxic agents
- Hypersensitivity to penicillins
- Hx of GI disease
- Seizure disorder
Pregnancy Category:B
Breastfeeding: This drug is considered safe and compatible with breastfeeding based upon data from LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 17 May 2010). Manufacturer advises caution
