Cefoxitin
Cefoxitin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Cefoxitin
ATX code: J01DC01
Active ingredient: cefoxitin (Cefoxitin)
Producer: Company DEKO, LLC (Russia)
Description and photo update: 02.04.
Cefoxitin is a cephalosporin antibiotic.
Release form and composition
The drug is produced in the form of a powder for the preparation of a solution for intravenous (iv) and intramuscular (i / m) administration: white with a yellow tint or white (500 or 1000 mg of active ingredient in a 10 ml vial, hermetically sealed with a rubber stopper and crimped cap, in a cardboard box 1 bottle and instructions for use of Cefoxitin; for hospitals - in a cardboard box 50 bottles).
Composition for 1 bottle: cefoxitin (in the form of sodium cefoxitin) - 500 or 1000 mg.
Pharmacological properties
Pharmacodynamics
Cefoxitin belongs to the antibiotics of the second generation cephalosporin group, has a wide spectrum of action. The agent is used for parenteral administration, exhibits a bactericidal effect, interfering with the synthesis of the cell wall of the microorganism.
The drug demonstrates activity against Staphylococcus aureus and Staphylococcus epidermidis (including strains producing and non-producing penicillinase). Shows high activity against gram-negative bacteria, such as Enterobacter spp., Haemophilus influenzae, Proteus mirabilis, Escherichia coli, Eikenella corrodens (strains that do not produce β-lactamase), Neisseria gonorrhoeae (including those producing and non-producing strains of penicillin), Morganella morganii, Providencia rettgeri, Providencia spp.
The antibiotic is active against the following anaerobic microorganisms: Clostridium spp., Peptostreptococcus spp., Peptococcus niger, Bacteroides spp. (including Bacteroides distasonis, Bacteroides thetaiotaomicron, Bacteroides fragilis, Bacteroides ovatus). Demonstrates resistance to β-lactamases.
Cefoxitin is inactive against various types of Pseudomonas spp., Many strains of Enterobacter cloacae (methicillin-resistant), Staphylococcus epidermidis and Staphylococcus aureus (methicillin-resistant strains), Listeria monocytogenes, Streptococcus pneumococcus haemolypto Most Enterococcus spp. (including Enterococcus faecalis) are resistant to the drug.
Pharmacokinetics
With intravenous administration, the maximum concentration (C max) of the active substance is observed at the end of the infusion, while after the administration of the drug at a dose of 1000 and 2000 mg C max is approximately equal to 110 and 244 μg / ml, respectively. The agent passes well into the joint cavity, pleural cavity, and is detected in antibacterial concentrations in bile. The drug binds to plasma proteins by 70–80%, the volume of distribution (V d) is 0.16 l / kg.
The half-life (T 1/2) is approximately 0.7-1.1 hours. In children, T 1/2 is: in newborns under the age of 7 days of life - approximately 5.6 hours; in infants aged 7-30 days - about 2.5 hours; at the age of 1-3 months - about 1.7 hours. The agent is excreted mainly unchanged (as a result of glomerular filtration - 85%, tubular secretion - 6%), in the form of inactive metabolites - from 0.2 to 5%.
In renal failure, T 1/2 of cefoxitin is about 5-6 hours.
Indications for use
The antibiotic Cefoxitin is recommended for the treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- respiratory tract infections;
- infections of bones and joints;
- infections of soft tissues and skin;
- infections of the urinary tract and pelvic organs;
- abdominal infections;
- endocarditis;
- sepsis;
- uncomplicated gonorrhea;
- postoperative infectious complications (for prevention).
Contraindications
Absolute:
- pregnancy;
- breast-feeding;
- hypersensitivity to the active substance, other drugs of the cephalosporin series and penicillins, the rest of the β-lactam antibiotics.
With extreme caution, treatment with Cefoxitin should be carried out in the presence of hepatic and / or renal failure, indications of a history of colitis.
Cefoxitin, instructions for use: method and dosage
The drug is administered intravenously (bolus / infusion) and intramuscularly.
For adults, the average dose is 1000-2000 mg every 6-8 hours.
Recommended dosing regimen for adults:
- uncomplicated urinary tract infections: i / m 2 times a day, 1000 mg;
- uncomplicated gonorrhea, including those excited by strains producing penicillinase: a single dose of 2000 mg intramuscularly (or after 1 hour) with probenecid administered orally at a dose of 1000 mg;
- severe infections: intravenous every 4 hours, 2000 mg or every 6 hours, 3000 mg; an increase in the daily dose up to 200 mg / kg is allowed, but not more than 12,000 mg;
- postoperative infections (for prophylaxis): 2000 mg intramuscularly or intravenously, 0.5–1 hour before the start of the surgical intervention and after it every 6 hours for 1 day.
For children, Cefoxitin is prescribed in a single dose of 30-40 mg / kg, the frequency of injections per day is set depending on age:
- premature babies weighing more than 1500 g and newborns of the first week of life: 2 times (after 12 hours);
- newborns 1–4 weeks of life: 3 times (after 8 hours);
- children over 1 month old: 3 or 4 times (after 8 or 6 hours).
In children, the maximum daily dose is 12,000 mg.
To prevent postoperative infections, children are prescribed the drug at a dose of 30–40 mg / kg 0.5–1 hours before the operation and every 6 hours for 1 day after the operation, however, the second and third doses are administered to newborns every 8–12 hours.
When performing a cesarean section, Cefoxitin is prescribed intravenously at the same time after clamping the umbilical cord at a dose of 2000 mg.
In patients with impaired renal excretory function, the first dose of the drug should be 1000–2000 mg; in the future, it is necessary to reduce the single dose and lengthen the intervals between injections.
The dosage regimen of Cefoxitin for impaired renal function, taking into account creatinine clearance (CC):
- CC 30-50 ml / min: every 8-12 hours, 1000-2000 mg;
- CC 10-29 ml / min: every 12-24 hours, 1000-2000 mg;
- CC 5-9 ml / min: every 12-24 hours, 500-1000 mg;
- CC below 5 ml / min: every 24–48 hours, 500–1000 mg.
Patients receiving hemodialysis treatment are advised to additionally use Cefoxitin at a dose of 1000–2000 mg after each procedure.
Children with impaired renal function should reduce the single dose and increase the interval between injections in accordance with the recommendations for adults with renal impairment.
Preparation of solutions depending on the method of administration:
- IV infusion: 500 or 1000 mg of the drug is diluted in 50 or 100 ml of solvent, respectively; solvents - solutions of sodium chloride 0.9% or dextrose 5%; the duration of the infusion - 30-60 minutes;
- IV bolus injection: 500 or 1000 mg of the drug is dissolved in 5 or 10 ml of water for injection, respectively; the introduction is carried out slowly, over 3-5 minutes;
- i / m introduction: 500-1000 mg of the drug is dissolved in 2 ml of water for injection or lidocaine solution (without epinephrine) 0.5-1%.
Side effects
- cardiovascular system: lowering blood pressure (BP);
- digestive system: loss of appetite, dry mouth, nausea, diarrhea, vomiting, pseudomembranous colitis;
- genitourinary system: renal failure, interstitial nephritis;
- hematopoietic organs: granulocytopenia, neutropenia, leukopenia, thrombocytopenia, anemia, hemolytic anemia, bone marrow suppression;
- allergic reactions: fever, shortness of breath, rash, eosinophilia, toxic epidermal necrolysis (Lyell's syndrome), exfoliative dermatitis, angioedema, anaphylactic reactions;
- laboratory indicators: against the background of azotemia, a false-positive Coombs' reaction is possible, an increase in the activity of hepatic transaminases;
- local reactions: with intravenous injection - phlebitis, with intramuscular injection - pain and hyperemia at the injection site;
- others: increased severity of the course of myasthenia gravis.
Overdose
In case of an overdose of Cefoxitin, the severity of undesirable phenomena, except for allergic reactions, increases. Therapy is prescribed symptomatic.
special instructions
When treating newborns with cefoxitin, a preservative-free solvent is required. In children, the use of high doses of the drug is accompanied by an increase in the activity of asparagine aminotransferase and an increase in the incidence of eosinophilia.
The drug is not recommended for the treatment of meningitis.
If the Jaffe method is used to determine the level of creatinine, falsely increased serum concentrations of the latter in the blood are possible.
During the period of treatment with the drug, as well as 14-21 days after the completion of the course of therapy, there is a risk of developing diarrhea caused by Clostridium difficile (pseudomembranous colitis). If this complication occurs in mild cases, antibiotic treatment is canceled and ion exchange resins (colestipol, colestyramine) are used. In severe cases, measures are required to replace the loss of electrolytes, fluid, protein, as well as the use of vancomycin, metronidazole or bacitracin. Medicines that have an inhibitory effect on intestinal peristalsis are contraindicated.
Influence on the ability to drive vehicles and complex mechanisms
Patients driving vehicles or other complex and potentially dangerous machinery should be careful during therapy.
Application during pregnancy and lactation
The use of the cephalosporin antibiotic Cefoxitin is contraindicated in pregnant women.
For the period of drug treatment, breastfeeding should be discontinued.
Pediatric use
The use of Cefoxitin in children is allowed according to the dosage regimen.
With impaired renal function
For patients with impaired renal function, the drug is prescribed with extreme caution.
In patients with impaired renal excretory function, the first dose of Cefoxitin should be 1000-2000 mg; in the future, it is necessary to reduce the single dose and lengthen the intervals between injections.
For patients with impaired renal function, the dosage regimen of the drug is set taking into account creatinine clearance (CC):
- CC 30-50 ml / min: every 8-12 hours, 1000-2000 mg;
- CC 10-29 ml / min: every 12-24 hours, 1000-2000 mg;
- CC 5-9 ml / min: every 12-24 hours, 500-1000 mg;
- CC below 5 ml / min: every 24–48 hours, 500–1000 mg.
Patients receiving hemodialysis treatment are advised to additionally use Cefoxitin at a dose of 1000–2000 mg after each procedure.
Children with impaired renal function should reduce the single dose and increase the interval between injections in accordance with the recommendations for adults with renal impairment.
For violations of liver function
For patients with impaired hepatic function, Cefoxitin is prescribed with extreme caution.
Drug interactions
- other cephalosporins; aminoglycosides: the threat of nephrotoxicity is aggravated;
- drugs that block tubular secretion: the content of cefoxitin in the blood and the duration of its effect increase.
Analogs
Analogues of Cefoxitin are Anaerocef, Ambitsef, etc.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C, in a place protected from moisture and light. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews of Cefoxitin
There are currently no reviews of Cefoxitin, therefore, it is not possible to objectively assess the effectiveness and disadvantages of this drug.
Price for Cefoxitin in pharmacies
The price of Cefoxitin is unknown, since the antibiotic is not currently sold in pharmacies.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
