Cefoxitin

How it works

It is a beta-lactam that inhibits bacterial cell-wall synthesis by binding penicillin-binding proteins, producing a bactericidal effect, and is relatively stable to some bacterial beta-lactamases.

Prescribing in practice

• Avoid in patients with a history of immediate hypersensitivity to penicillins or other beta-lactams because of the risk of cross-reactivity.
• Its anaerobic cover makes it useful for mixed infections, but local resistance patterns and microbiology advice should guide use.
• Dose adjustment is required in significant renal impairment, in line with the SPC.

Monitoring

Monitor renal function and clinical response, especially during prolonged therapy or in renal impairment.

Counselling the patient

• This antibiotic is given by injection or infusion under clinical supervision.
• Report any rash, swelling, breathing difficulty, or severe or persistent diarrhoea.

Evidence & guidelines

Its role in surgical and intra-abdominal infection is established in standard microbiology and prescribing references rather than a single landmark trial.