Cefoxtin is a second-generation cephalosporin antibiotic used to treat bacterial infections. Cefoxitin was initially approved by the FDA in 1978 for clinical use. It is effective against a broad range of Gram-positive and Gram-negative bacteria and is commonly used for intra-abdominal infections, pelvic infections, and surgical prophylaxis. Cefoxitin works by inhibiting bacterial cell wall synthesis, leading to bacterial cell death. It is generally well-tolerated and considered a safe and efficient therapy for treating susceptible bacterial infections.
BRAND NAMES
Common brand names of Cefoxitin include:
Mefoxin
Foxitin
MECHANISM OF ACTION
Cefoxitin is a second-generation cephalosporin antibiotic that works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs), preventing the cross-linking of peptidoglycan in the bacterial cell wall, which weakens the wall and leads to bacterial lysis and death.
PHARMACOKINETICS
Absorption
Cefoxitin is typically administered intravenously or intramuscularly, which allows it to bypass the gastrointestinal tract and achieve complete bioavailability. Because it is not given orally, absorption from the gut is not clinically relevant, ensuring rapid and reliable delivery of the drug into the bloodstream for effective antibacterial action.
Distribution
Cefoxitin is distributed mainly in body fluids and tissues, with a volume of distribution of approximately 0.2 L/kg. It penetrates well into peritoneal, biliary, and pleural fluids, making it effective for treating infections in these areas.
Metabolism
Cefoxitin undergoes limited hepatic metabolism, with most of the drug remaining unchanged. The majority is eliminated unchanged by the kidneys, which contributes to its predictable antibacterial activity.
Excretion
Cefoxitin is primarily excreted unchanged in the urine, with a half-life of approximately 1 hour. Renal function affects its clearance, so dosage adjustments may be needed in patients with impaired kidney function.
PHARMACODYNAMICS
Cefoxitin is a second-generation cephalosporin that works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins, preventing the cross-linking of peptidoglycan in the bacterial cell wall, which weakens the wall and leads to bacterial lysis and death. It is effective against Gram-positive, certain Gram-negative, and anaerobic bacteria.
DOSAGE AND ADMINISTRATION
Cefoxitin is usually administered intravenously (IV) or intramuscularly (IM). Adult doses are typically 1–2 g every 6–8 hours, depending on the severity and type of infection. Pediatric doses are weight-based, and adjustments may be needed in patients with renal impairment. It is not given orally.
CONTRAINDICATIONS
Cefoxitin is contraindicated in patients with a known allergy to cefoxitin, other cephalosporins, or penicillins, due to the risk of severe hypersensitivity reactions.
DRUG INTERACTIONS
Cefoxitin may interact with aminoglycosides or loop diuretics, increasing the risk of kidney toxicity. It can also reduce the effectiveness of live bacterial vaccines and may interact with anticoagulants, potentially affecting blood clotting.
SIDE EFFECTS
Diarrhea
Nausea and vomiting
Rash or skin reactions
Injection site reactions (pain, swelling)
Rare: allergic reactions (anaphylaxis)
Rare: changes in blood counts (e.g., leukopenia)
Rare: kidney problems (nephrotoxicity)
OVER DOSE
May cause seizures (rare)
Can lead to kidney dysfunction or electrolyte imbalances
May cause gastrointestinal upset (nausea, vomiting, diarrhea)
TOXICITY
Cefoxitin toxicity can cause seizures, kidney damage, blood count changes, and severe gastrointestinal upset in cases of high doses or prolonged use. Management focuses on discontinuing the drug and providing supportive care.
