Cefoxitin

Antibiotics in this group are Cephamycin derivatives
Antibiotic coverage spectrum
1. Gram Positive activity (but less than Second Generation Broad-spectrum Cephalosporins such as Cefuroxime)
2. Gram Negative coverage
3. Anaerobic coverage (e.g. Bacteroides)

Typical Dose
1. Give 1 to 2 g IV every 6 to 8 hours
High Dose (Severe Infections)
1. Give 3 g IV every 6 hours
Surgical Prophylaxis
1. Give 2 g IV 30 to 60 min before surgery (or for Cesarean Section, after Umbilical Cord clamped)
2. May continue 2 g IV every 6 hours for 24 hours
Renal Dosing
1. eGFR 30 to 50 ml/min: 1 to 2 g IV every 8 to 12 hours
2. eGFR 10 to 29 ml/min: 1 to 2 g IV every 12 to 24 hours
3. eGFR 5 to 9 ml/min: 0.5 to 1 g IV every 12 to 24 hours
4. eGFR <5 ml/min: Load 1 to 2 g IV, then 0.5 g IV every 24 to 48 hours
  1. Give additional 1 to 2 g IV after Hemodialysis

Typical Dose
1. Give 80 to 100 mg/kg/day IV divided every 6 to 8 hours
High Dose (severe infections)
1. Give 160 mg/kg/day IV divided every 6 to 8 hours

Lab abnormalities in children after high dose regimens
1. Eosinophilia
2. Aspartate Aminotransferase (AST) increased