Cefoxitin (Mefoxin) is an intravenous cephamycin antibiotic (sometimes classified as a second-generation cephalosporin subgroup) that binds penicillin-binding proteins thereby disrupting the formation of bacterial cell walls. Compared to first-generation cephalosporins like cefazolin, cefoxitin is less active against Staph species. As a tradeoff, it has activity against some gram-negative rods, and to a lesser extent, anaerobes like Bacteroides although resistance has become a significant issue. Consequently, other options are utilized for serious intraabdominal infections.
The only time I’ve administered cefoxitin is for surgical antibiotic prophylaxis prior to genitourinary or abdominal surgery for activity against facultative gram-negative rods and aerobic organisms. Personally, I feel that there are better options, but I’ll leave that to the infectious disease specialists! prophylactic antibiosis at the request of my surgical colleagues prior to surgery in the abdominal and/or pelvic cavities.
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