Cefoxitin Administration and Safety
Dosing and Administration
- The standard dosing for cefoxitin when administered intravenously is 200 mg/kg/day in three divided doses (maximum 12 g/day) for adults, and 150 mg/kg/day in 3-4 divided doses (maximum 12 g/day) for children aged 1 month and above, according to the American Thoracic Society 1, 2
- Cefoxitin provides flexibility in treatment settings where IV access is limited, similar to other cephalosporins like ceftriaxone, which can be administered IM for certain infections 3
Monitoring and Safety Considerations
- Routine toxicity monitoring should be performed intermittently throughout treatment with cefoxitin, regardless of administration route, including monitoring for hypersensitivity reactions, maculopapular rash, urticaria, transient increases in liver enzymes, and potential hematological effects like leucopenia and thrombocytopenia 1, 2
- Serious but rare adverse effects include seizures, acute renal failure, and toxic nephropathy 1, 2
Important Drug Interactions
- Cefoxitin may interact with aminoglycosides, increasing the risk of nephrotoxicity 1
- Cefoxitin may interact with anticoagulants, increasing INR with warfarin 2
- Cefoxitin may interact with furosemide, increasing the risk of nephrotoxicity 2
- Cefoxitin may interact with probenecid, reducing renal excretion of cefoxitin and resulting in increased and prolonged serum levels 1, 2