Classes
DEA Class; Rx
Common Brand Names;
- Cephalosporins, 2nd Generation
Description
Second-generation cephalosporin with activity against some gram-positive cocci, gram-negative rod infections, and anaerobic bacteria. Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins; inhibits final transpeptidation step of peptidoglycan synthesis, resulting in cell wall death
Indications
Indicated for the treatment of Uncomplicated Infections, Moderate-Severe Infections, Gas Gangrene, Surgery Prophylaxis.
Prevention of infection
Also indicated in Bacteroides spp., Clostridium spp., Enterobacter, E. coli, H. influenzae, Klebsiella spp., Peptococcus spp., Peptostreptococcus spp., Proteus mirabilis, S. aureus, S. pneumoniae, group A beta-hemolytic Streptococcus infections.
Contraindications
Documented hypersensitivity
Neonate (<3 mo)
Adverse Effects
- Diarrhea
- Anemia
- Eosinophilia
- Transient leukopenia
- Thrombocytopenia
- SCr & BUN increased
- Elevated LFT’s
Warnings
Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity); superinfections, and promotion of non-susceptible organisms may occur with prolonged use or repeated therapy
Pregnancy and Lactation
Available data from published prospective cohort studies, case series, and case reports with cephalosporin use in pregnant women have not established drug- associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Limited data from published literature report presence of drug in human milk
Maximum Dosage
Adult
Uncomplicated Infections
1 g IV q6-8hr; 3-4 g/day maximum
Moderate-Severe Infections
1 g IV q4hr or 2 g IV q6-8hr; 6-8 g/day maximum
Gas Gangrene
Infections commonly requiring antibiotics in higher dosage
2 g IV q4hr or 3 g IV q6hr; 12 g/day maximum
Surgery Prophylaxis
Prevention of infection
Colorectal, non-perforated appendectomy, hysterectomy: 1-2 g IV
Ruptured viscus: 1-2 g IV q6hr
How supplied
Cefoxitin
powder for injection
- 1g
- 2g
- 10g