Careful inquiry should be made before therapy with Kalfoxim to detect any previous hypersensitivity reactions to cephalosporins, penicillins or other drugs.
Kalfoxim should be given with caution to patients who are hypersensitive to penicillins, because cross-reactions have been reported. Special care is indicated in patients who have had an anaphylactic response to penicillin. If an allergic reaction to Kalfoxim occurs, discontinue the drug.
As with other broad-spectrum antibiotics, prolonged use of Kalfoxim may result in overgrowth of nonsusceptible bacteria and fungi (including C. difficile). If superinfections (including pseudomembranous colitis) occur during therapy, appropriate measures should be taken.
Use Kalfoxim with caution in patients with a history of gastrointestinal disease, particularly colitis.
In severe renal dysfunction, Kalfoxim dosage should be reduced (see Dosage & Administration).
Kalfoxim at high dosage may enhance the nephrotoxicity of aminoglycoside antibiotics or potent diuretics eg, furosemide; therefore, this combination should be given with caution. At recommended dosage, however, Kalfoxim is unlikely to cause this enhancement.
Use in pregnancy: Although in animal studies Kalfoxim has not been shown to produce harmful effects on the fetus, its safety in human pregnancy has not been established. Therefore, Kalfoxim should be used during pregnancy (especially during the 1st trimester of pregnancy) only if absolutely needed.
Use in lactation: Kalfoxim is excreted in human milk in low concentrations. Therefore, it should be used with caution in nursing mothers.