1. 50 mg/kg/dose IV injection over 3-5 minutes, or IM. 
    

   Postmenstrual Age (weeks)	Postnatal Age (days)	Dosing Interval (hr)
   <29	0 to 28	12
   	>28	8
   30 to 36	0 to 14	12
   	>14	8
   37 to 44	0 to 7	12
   	>7	8
   >45	All	6

Indications

1. Empirical therapy for infants with risk factors for sepsis, or suspected sepsis.
   Usually administered in combination with amoxycillin.

Contraindications and Precautions

1. Hypersensitivity to penicillins/cephalosporins.
2. Caution in preterm infants, especially extreme immaturity.
3. Caution in infants with liver, renal or gastrointestinal disease.

Clinical Pharmacology

Bacteriocidal semisynthetic beta-lactam cephalosporin antibiotic for parenteral administration. Has broad spectrum of antibacterial activity against gram positive and gram negative pathogens, both aerobic and anaerobic. Cefoxitin is not active against Listeria monocytogenes, Streptococcus faecalis, Pseudomonas spp, and most strains of enterococci. Action is by inhibition of bacterial wall synthesis.

Widely distributed at varying concentrations in human body tissues and fluids. Very little passes into the CSF unless the meninges are inflamed. Moderate binding (70%) to human plasma protein. It is excreted virtually unchanged via the kidneys. Tubular excretion is inhibited by probenecid.

Possible Adverse Effects

1. Venous irritation, soft tissue injury at IV injection site.
2. Pain, soft tissue injury at IM injection site.
3. Rash, pruritus, urticaria.
4. Gastrointestinal disturbance (nausea, vomiting, diarrhoea).
5. Anaemia, neutropenia, thrombocytopenia.
6. Transient elevation of hepatic enzymes.
7. Elevation of serum creatinine.
8. Super-infection with non susceptible organisms including fungi.
9. Hypotension.

Special Considerations

1. Cefoxitin at high dosage should be given with caution to those infants receiving aminoglycosides or potent diuretics.
2. Adjust dose in suspected renal dysfunction (usually by lengthening the dosing interval).
3. Sodium content 2.3 mmol/gm.
4. May be associated with false positive glycosuria, falsely high serum creatinine (using Jaffe technique), and a false elevation of urinary 17-hydroxycorticosteroids.