Cefoxitin

General Information

Do NOT use if patient has a history of severe penicillin allergy. If in doubt, discuss with Micro/ID.

Restricted formulary antimicrobial: For details see OUH netFormulary

AWaRe antibiotic classification: 'Watch'. Use as per guidelines. All other indications to be discussed with Micro/ID.

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Intravenous dose

Standard dose

2g every 4-6 hours;

maximum 12g per day

No dose adjustment required

Renal impairment

Creatinine clearance (ml/min)*	Dose
30-50	2g every 8-12 hours
10-29	2g every 12-24 hours
5-9	2g loading dose then 500mg-1g every 12-24 hours
Less than 5	2g loading dose then 500mg-1g every 24-48 hours
HD/HDF	2g every 24 hours Dialysed; give after dialysis
PD	1g every 24 hours Not dialysed

*dose ranges use creatinine clearance, rather than eGFR

Hepatic impairment

No dose adjustment required

Warfarin – Rare cases of bleeding have been reported. Monitor INR closely, particularly within 3 days of starting or stopping cefoxitin.

This is not a complete list. Please see the BNF, Summary of Product Characteristics or speak to a pharmacist.

Pregnancy

Use only if benefit outweigh the risks

Breastfeeding

Discuss with pharmacy

Renal function should be monitored during treatment if cefoxitin is given in combination with other potentially nephrotoxic antibiotics (especially aminoglycosides), or with furosemide or etacrynic acid diuretics.

Renascience Pharma Ltd. Summary of Product Characteristics (SPC). Renoxitin 1g Powder for solution for Injection or Infusion. [on-line] Last revision of the text: 14/5/25. Accessed via www.medicines.org.uk. Accessed 5/9/25
The Renal Drug Database. Cefoxitin Sodium. [online]. Last updated 31/10/23. Accessed via https://renaldrugdatabase.com Accessed 5/9/25
BNF online accessed via www.medicinescomplete.com Accessed 5/9/25

Sanford Guide. Cefoxitin. Last revision of the text: 27/6/25. Accessed via https://webedition.sanfordguide.com Accessed 5/9/25
Sanford Guide. Obesity dosing adjustment [Internet] Last revision of the text: 2/9/25. Accessed via https://webedition.sanfordguide.com Accessed 5/9/25
Stockley IH. Stockley’s Drug Interactions. Available from: https://www.medicinescomplete.com