Mefoxin

Generic Name: Cefoxitin sodium
Product Name: Mefoxin

Indication

Cefoxitin sodium is for the treatment of the following infections when they are caused by susceptible organisms:
– infections in the abdomen and pelvis
– female genital tract infections
– blood infection
– heart valve infection
– urinary tract infections
– respiratory tract infections
– bone and joint infections
– skin and skin structure infections
Cefoxitin sodium can also be used in combination with surgical drainage in the treatment of:
– abscesses
– organ perforation complicated by infection
– cutaneous infection
– infection of serous surfaces
Post operative infections following gastrointestinal, biliary or genital surgery may be treated with Cefoxitin.
In the treatment of any infection, it is important to isolate the bacteria and its antibacterial susceptibilities if possible before commencing treatment.

Action

Cefoxitin is from the cephalosporin family of antibiotics and is a second-generation cephalosporin. It kills bacteria by inhibiting production of an important component of bacterial cell walls. It is active against a large number of aerobic (those that require oxygen) and anaerobic (those that can grow without oxygen) bacteria. Some well-known bacteria that Cefoxitin is active against include:
– Staphylococcus aureus
– Streptococcus pneumoniae
– E. coli
– Neisseria gonorrhoea, the bug responsible for gonorrhoea
– Neisseria meningitidis (meningococcus)
– the food poisoning bugs Salmonella and Shigella
– Propionibacterium acnes, the bug responsible for the skin condition acne vulgaris
Cefoxitin is not active against Pseudomonas and Enterococci, which are bugs that can cause serious in-hospital infections.

Dose advice

Cefoxitin sodium for injection is to be used intravenously and intramuscularly.
Adults
– usual dose is 1-2g every eight hours, with 3g every 4-6 hours being used in serious infections
– total daily dose should not exceed 12g
Renal impairment
– loading dose of 1-2g should be given
– dosage adjustment should then be made depending on renal function
Uncomplicated gonorrhoea
– single dose of 2g given IM simultaneously with oral dose of 1g probenecid to slow excretion of the antibiotic
Children
Neonates up to 1 week
– 20-40mg/kg every 12 hours
– dosage for premature infants has not been established
Neonates 1-4 weeks of age
– 20-40mg/kg every 8 hours
Infants and children over 3 months of age
– 20-40mg/kg every 6-8 hours
Prophylaxis
Cefoxitin sodium can be used for prophylaxis of infection following surgery.
Adults
– 2g intramuscularly 1 hour before initial incision; or
– 2g intravenously immediately before surgery; then
– 2g repeated twice at 6 hourly intervals
Children
– 30-40mg/kg IM 1 hour before initial incision; or
– 30-40mg/kg intravenously immediately before surgery; then
– 30-40mg/kg repeated twice at 6 hourly intervals
Neonates
– 30/40mg/kg one hour before surgery; then
– one further dose after 8-12 hours
For intravenous injection
– solutions containing benzyl alcohol should not be used as diluents in neonates
– 1g of Cefoxitin sodium for injection is soluble in 2ml of water for injection, but 10ml is preferred for the 1g vial, and 20ml for the 2g vial
– inject slowly over 3-5 minutes or give through tubing of concurrent intravenous fluid
For continuous intravenous infusion
– Cefoxitin sodium can be given as a continuous infusion diluted in a larger amount of compatible fluid
For intramuscular injection
– 1g Cefoxitin sodium should be reconstituted in 2ml of lignocaine hydrochloride (0.5-1%)
– for patients hypersensitive to lignocaine, water for injections can be used, with a warning that the injection will be painful
– the 2g vial should be reconstituted in 4ml of diluent
– injection should be given into a large muscle mass

Schedule

S4

Common side effects

Cefoxitin sodium is generally a well-tolerated drug. Adverse effects that occur are usually mild and transient, and include:
– inflammation of the vein at the injection site
– nausea
– diarrhoea

Uncommon side effects

– vomiting
– low blood pressure
Allergic reactions to Cefoxitin occur rarely, but the symptoms are important to know and should be reported to a doctor:
– rash
– hives
– itching
– fever
– trouble breathing
– wheezing

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For further information talk to your doctor.