Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Mefoxitin; France: Cefoxitine; Germany: Mefoxitin; Greece: Mefoxil; Italy: Cefociclin IM, Mefoxin; Portugal: Atralxitina, Cefoxitina.

North America

Canada: Cefoxitin; USA: Cefoxitin.

Latin America

Argentina: Cefoxitina; Brazil: Cefoxitina, Gamacef, Kefox.

Drug combinations


Cefoxitin Sodium: C~16~H~16~N~3~NaO~7~S~2~. Mw: 449.43. (1) 5-Thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid, 3-[[(aminocarbonyl)oxy]methyl]-7-methoxy-8-oxo-7-[(2-thienylacetyl)amino]-, sodium salt, (6R-cis)-; (2) Sodium (6R,7S)-3-(hydroxymethyl)-7-methoxy-8-oxo-7-[2-(2-thienyl)acetamido]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate carbamate. CAS-33564-30-6; CAS-35607-66-0 (cefoxitin)(1979).

Pharmacologic Category

Antibacterials; Miscellaneous β-Lactams; Cephamycins. (ATC-Code: J01DC01).

Mechanism of action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins. Usually bactericidal. Active in vitro and in clinical infections against S. aureus (including penicillinase-producing strains), S. epidermidis, S. pneumoniae, S. pyogenes (group A β-hemolytic streptococci), and S. agalactiae (group B streptococci). Oxacillin-resistant staphylococci (methicillin-resistant staphylococci) and most enterococci (e.g. Enterococcus faecalis) are resistant. Active in vitro and in clinical infections against E. coli, H. influenzae, Klebsiella (including K. pneumoniae), M. morganii, N. gonorrhoeae, P. mirabilis, P. vulgaris, and Providencia (including P. rettgeri). Also active in vitro against Eikenella corrodens (non-β-lactamase-producing strains), K. oxytoca, Salmonella, and Shigella. Many strains of Enterobacter cloacae and most strains of Pseudomonas aeruginosa are resistant. Active in vitro and in clinical infections against anaerobes such as Bacteroides distasonis, B. fragilis, B. ovatus, B. thetaiotaomicron, Clostridium (including C. perfringens but not C. difficile), Peptococcus niger, and Peptostreptococus. Also active in vitro against Fusobacterium, Prevotella bivia, Propionibacterium. It is inactive against Chlamydia, fungi, and viruses.

Therapeutic use

Respiratory tract, skin and skin structure, bone and joint, urinary tract and gynecologic infections as well as septicemia. Surgical prophylaxis. Intra-abdominal infections and other mixed infections. Bacterial Eikenella corrodens infections.

Pregnancy and lactiation implications

Adverse events not observed in animal reproduction studies. Cefoxitin crosses the placenta and reaches the cord serum and amniotic fluid. Adequate studies are not available in pregnant women. Pregnancy-induced hypertension increases trough concentrations in the immediate postpartum period. Enters breast milk (small amounts).

Unlabeled use


Hypersensitivity to cefoxitin, any component of the formulation, or other cephalosporins.

Warnings and precautions

Use with caution in history of penicillin allergy, especially IgE-mediated reactions (e.g. anaphylaxis, angioedema, urticaria). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in renal impairment. May cause positive direct Coombs’ test, false-positive urinary glucose test using cupric sulfate, false-positive serum or urine creatinine with Jaffé reaction.



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