Cefoxitin

Y. Vivian Tsai, Pharm.D., Edina Avdic, Pharm.D.

INDICATIONS

Note: many of the listed indications do not reflect contemporary use of this drug.
Lower respiratory tract infections
- Including pneumonia and lung abscess
- FDA-labeled but rarely used and not included in contemporary guideline-recommended pneumonia regimens.
Urinary tract infections
Intra-abdominal infections
- Including peritonitis and intra-abdominal abscess (IDSA guidelines: mild-moderate community-acquired infections only)
  - While the older 2010 SIS/IDSA recommendation recommended cefoxitin for mild-to-moderate community-acquired infection, the 2017 SIS recommendation is specifically: do not use cefoxitin or cefotetan routinely for empiric therapy, Grade 2-B
Gynecologic infections
- Including endometritis, pelvic cellulitis and pelvic inflammatory disease
- Pelvic inflammatory disease, in combination with doxycycline; outpatient regimens also include metronidazole.
Septicemia caused by S. pneumoniae, S. aureus (MSSA), E. coli, Klebsiella species, and Bacteroides species including B. fragilis
- FDA-labeled; generally not preferred for bloodstream infection because more reliably active and better-studied agents are available.
Bone and joint infections
- FDA-labeled but rarely used; not preferred for MSSA osteoarticular infection.
Skin and skin-structure infections

Surgical prophylaxis (GI, abdominal hysterectomy, vaginal hysterectomy, Cesarean section)
Infections due to susceptible rapidly growing nontuberculous mycobacteria, principally M. abscessus complex, as one component of a multidrug regimen.

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