cefoxitin (Mefoxin)

Introduction

Tradename: Mefoxin. 2nd generation cephalosporin.

Indications

• treatment of bacterial infections due to susceptible organisms
  • urogenital infection
    • gonorrhea
    • pelvic inflammatory disease
    • endometritis
  • proctitis
  • pneumonia, pulmonary abscess
  • intra-abdominal infection
    • abdominal abscess
    • bacterial peritonitis
  • skin or soft tissue infection
    • cellulitis
  • infectious arthritis, osteomyelitis
• prophylaxis for perioperative infection
  • gastrointestinal surgery
  • transurethral resection of the prostate
  • hysterectomy
  • cesarean section

Dosage

1-2 g IV/IM every 6-8 hours

Antimicrobial activity

Gram positive

• Streptococcus
  • Streptococcus group A
  • Streptococcus group B
  • Streptococcus group C
  • Streptococcus group G
  • Streptococcus pneumonia
  • Streptococcus viridans, milleri
• Staphylococcus aureus (MSSA)
• Staphylococcus epidermidis (+/-)

Gram negative

• Neisseria gonorrhoeae
• Neisseria meningitidis
• Moraxella catarrhalis
• Haemophilus influenzae
• Escherichia coli
• Klebsiella species
• Salmonella species
• Shigella species
• Proteus mirabilis
• Proteus vulgaris
• Providencia species
• Morganella species
  • Morganella morganii
• Citrobacter species (+/-)
• Aeromonas species (+/-)
• Yersinia enterocolitica (+/-)
• Haemophilus ducreyi

Anaerobes

• Bacteroides fragilis
• Bacteroides melaninogenicus
• Clostridium species
• Peptostreptococcus species

Adverse effects

• hypersensitivity
• skin rash
• eosinophilia
• thrombocytopenia
• neutropenia
• leukopenia
• dyspepsia
• thrombophlebitis
• laboratory anomalies
  • positive direct Coomb's test
  • increased serum transaminases (AST, ALT)
  • increased serum alkaline phosphatase
  • increased serum urea nitrogen & creatinine

• drug adverse effects of cephalosporins

Laboratory

• specimen:
  • serum
  • keep specimen on ice-water
  • centrifuge at 4 degrees C
  • remove cells as soon as possible
  • freeze at -70 degrees C until assayed
• methods: HPLC, MB
• interferences:
  • cefoxitin reacts with picrate in Jaffe method of serum creatinine determination (falsely increases serum creatinine)

More general terms

• cephalosporin, 2nd generation

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441199
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=37194
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=36551
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5287917
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2637
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441392