Panafox

Panafox

cefoxitin

Manufacturer:

Panpharma Healthcare

Distributor:

Panpharma Healthcare
Full Prescribing Info
Contents
Cefoxitin sodium.
Description
Each gram of cefoxitin contains sodium 51.1 mg (2.2 mEq).
Action
Cefoxitin is a β-lactam antibacterial antibiotic from the cephalosporin group. Cefoxitin sodium is a cephamycin which, like other β-lactams, is bactericidal and is considered to act through the inhibition of bacterial cell wall synthesis.
Pharmacokinetics: Cefoxitin penetrates well into brain, kidney, lung and other body tissues. Protein-binding is 65-79%; volume of distribution is 6-8 L. Cefoxitin is <2% metabolized in the liver and is excreted predominantly unchanged in the urine. Serum t½ is 0.8 hr.
Indications/Uses
Treatment of intra-abdominal and pelvic infection and for surgical infection prophylaxis when contamination with anaerobes is likely for having a greater activity against anaerobic bacteria including Bacteroides fragilis. Indications include endometritis (prophylaxis at caesarian section), pelvic inflammatory disease, and surgical infection (prophylaxis). It may also be used in the treatment of gonorrhea and urinary tract infections.
Dosage/Direction for Use
Patients with Normal Kidney Function: Adults: 1-2 g IM/IV every 8 hrs; up to 12 g daily in severe infections.
Children and Older Infants: 20-40 mg/kg body weight every 6-8 hrs.
Neonates 1-4 weeks: 20-40 mg/kg body weight every 8 hrs; Neonates up to 1 week: 20-40 mg/kg body weight every 12 hrs.
In severe infections up to 200 mg/kg daily to maximum of 12 g daily. Prophylaxis: Postoperative Surgical Infections: Adults: 2 g per IV route when inducing anesthesia, followed by injections of 1-2 g every 2 hrs until the skin has closed up. Antibioprophylaxis must be short; mostly limited to postoperation period, sometimes up to 24 hrs, but never exceeds 48 hrs.
Children and Infants: 30-40 mg/kg body weight every 6 hrs.
Neonates: 30-40 mg/kg interval of 8-12 hrs.
Appendectomy: A single dose is sufficient.
Uncomplicated UTI: 1 g 2 times daily for IM.
Uncomplicated Gonorrhea: Single dose of 2 g IM with probenecid 1 g by mouth.
Caesarian Section: A single 2-g dose may be given IV to the mother as soon as the umbilical cord is clamped.
IV route is recommended for children.
Patients with Renal Impairment: Adults: Initial Dose: 1-2 g.
Maintenance: See table.

Click on icon to see table/diagram/image

Administration: IM: Reconstitute the solution in 2 mL of water for injection.
IV: Add 10 mL of water for injection. The solution can be administered by slow direct IV injection or through intermittent or continuous infusion.
IV Infusion: The solution obtained after dilution in 10 mL of water for injection can be added to one of the following solutions which are of common use through infusion: 0.9% sodium chloride injection, 5% or 10% dextrose injection, dextrose and sodium chloride injection (5%/0.9%), 5% dextrose injection in a 0.02% sodium bicarbonate solution, 5% dextrose injection in a 0.02 or 0.45% saline solution, lactated Ringer's solution, 5% dextrose injection in lactated Ringer's solution, 5% or 10% invert sugar in water for injection, 10% invert sugar in saline solution, 5% sodium bicarbonate injection, M/6 sodium lactate injection.
Whatever the diluent and the administration route, all these preparations must be used immediately after reconstitution or dilution.
Overdosage
No specific information is available on the treatment of cefoxitin overdosage.
Contraindications
Patients who are hypersensitive to cefoxitin sodium or to other cephalosporins.
Allergy to penicillins.
Special Precautions
Care is also necessary in patients with known histories of allergy. Cefoxitin sodium should be given with caution to patients with renal impairment. Renal and haematological status should be monitored especially during prolonged and high-dose therapy.
Adverse Reactions
Hypersensitivity reactions including skin rashes, urticaria, eosinophilia, fever, reactions resembling serum sickness, and anaphylaxis. Acute renal tubular necrosis has followed excessive dosage and has also been associated with its use in old patients or those with preexisting renal impairment or with the concomitant administration of nephrotoxic drugs eg, aminoglycoside antibiotics. Acute interstitial nephritis is also a possible manifestation of hypersensitivity.
Convulsions and other signs of central nervous system toxicity have been associated with high doses, especially in patients with renal failure. There may be pain at the site of injection site following IM injection and thrombophlebitis has occurred following IV infusion usually of >6 g daily for >3 days.
Drug Interactions
It is advised to monitor the kidney function during treatment, in case of association of cefoxitin with potentially nephritic antibiotics (especially aminoglycosides) or with diuretics eg, furosemide or ethacrynic acid. Positive Coombs' test have been reported during treatment with cephalosporin antibiotics. This may appear in patients receiving cefoxitin.
Incompatibilities: Cefoxitin solutions may be administered at the same time as other antibiotics. However, do not mix cefoxitin with another antibiotic in the same syringe or infusion tubing or inject/infuse through the same injection/infusion site.
Storage
Store away from light, in a cool dry place, below 25°C.
Shelf-Life: 2 years.
MIMS Class
ATC Classification
J01DC01 - cefoxitin ; Belongs to the class of second-generation cephalosporins. Used in the systemic treatment of infections.
Presentation/Packing
Powd for inj (vial) 1 g x 10's, 50's.
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