Cefoxitin

Drug Levels and Effects:




Summary of Use during Lactation:


Cefoxitin is acceptable to use during breastfeeding. Substantial information indicates that maternal doses of cefoxitin up to 4 grams daily produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally, disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush, has been reported with cephalosporins, but these effects have not been adequately evaluated.


Drug Levels:


Maternal Levels.

After a 1 gram dose of cefoxitin in one woman, the cefoxitin level in milk 2 hours after the dose was5.6 mg/L.[1][2]

Four postpartum women received 1 gram of cefoxitin three times a day. Only 8 of 50 breastmilk samples had measurable cefoxitin levels of0.8 to 1 mg/L. Other samples had unmeasurable (<0.8 mg/L) cefoxitin levels.[3]

Fifteen nursing others received a single intramuscular dose of cefoxitin 1 gram. Cefoxitin was not detected (<0.5mg/L) in any milk samples taken up to 24 hours after the dose.[4]

After a single 2 gram intramuscular dose of cefoxitin in5women, peak milk levels of0.31 to0.65 mg/L occurred 1 to5hours after the dose.[5]

Cefoxitin was not measurable in breastmilk at any time up to 6 hours after a single 1gram intravenous dose of cefoxitin in 2 women.[6]

Eighteen women undergoing cesarean section were given either a single 2 gram dose of cefoxitin or 2 grams followed by two 1 gram doses (route unspecified). Cefoxitin was detected (detection limit0.5mg/L) in the milk of only one woman at a concentration of0.9 mg/L 19 hours after the third dose of cefoxitin.[7]

Fifteen women were given a single 1 gram dose of cefoxitin intravenously at about 1 month after delivery. The average milk level 2 hours after the dose was0.05 mg/L.[8]

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Relevant published information was not found as of the revision date.


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


References:


1. Geddes AM, Schnurr LP, Ball AP et al. Cefoxitin: a hospital study. Br Med J. 1977;1:1126-8. PMID:861496
2. Geddes AM, McGhie D, Ball AP et al. Studies with cefuroxime and cefoxitin. Scand J Infect Dis. 1978;13 (Suppl):78-81. PMID:308260
3. Santo GH, Huch A. Ubergang von cefoxitin in muttermilch. Infection. 1979;7(Suppl 1):S90-1.
4. Dubois M, Delapierre D, Chanteux L et al. A study of the transplacental transfer and the mammary excretion of cefoxitin in humans. J Clin Pharmacol. 1981;21:477-83. PMID:7334140
5. Dresse A, Lambotte R, Dubois M et al. Transmammary passage of cefoxitin: additional results. J Clin Pharmacol. 1983;23:438-40. PMID:6643697
6. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy. 1984;5:57-60. PMID:6743732
7. Roex AJM, van Loenen AC, Puyenbroek JI et al. Secretion of cefoxitin in breast milk following short-term prophylactic adminstration in caesarean secretion. Eur J Obstet Gynecol Reprod Biol. 1987;25:299-302. PMID:3653494
8. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997;32(</span>5):288-92. PMID:9596854



Substance Identification:




Substance Name:

Cefoxitin

CAS Registry Number:

35607-66-0

Drug Class:


  • Antiinfective Agents

  • Antibacterial Agents

  • Cephalosporins


  • Administrative Information:




    LactMed Record Number:


    51


    Last Revision Date:


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