Cefoxitin

Cefoxitin, a second-generation cephalosporin, exerts its bactericidal effect by binding to and inactivating penicillin-binding proteins (PBPs) located in the bacterial cell wall. This action inhibits the transpeptidation step of peptidoglycan synthesis, which is crucial for bacterial cell wall cross-linking. The resulting defective cell wall integrity leads to increased osmotic pressure, cell lysis, and ultimately bacterial death.

Adult

For susceptible infections, cellulitis, erysipelas, acute diverticulitis, complicated urinary tract infection, pyelonephritis (by intravenous infusion, or by intravenous injection, or by intramuscular injection): 750 mg every 6-8 hours; increased if necessary up to 1.5 g every 6-8 hours, increased dose used for severe infections.…

Pediatric

For susceptible infections, cellulitis, erysipelas (by intravenous infusion, or by intravenous injection, or by intramuscular injection): 20 mg/kg every 8 hours (max. per dose 750 mg); increased to 50–60 mg/kg every 6–8 hours (max. per dose 1.5 g), increased dose used for severe infection and cystic fibrosis.

Renal adjustment

Manufacturer advises increase dosing interval to every 8-12 hours if creatinine clearance 30-50 mL/minute, or every 12-24 hours if creatinine clearance 10-29 mL/minute. Consult product literature if creatinine clearance less than 10 mL/minute.

Max dose

12 g per day (for Lyme disease)