Mefoxin Uses

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What is Mefoxin?

Mefoxin injection is used to treat bacterial infections in many different parts of the body. Mefoxin is also given before certain types of surgery to prevent infections.

Mefoxin injection belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, Mefoxin will not work for colds, flu, or other virus infections.

Mefoxin is available only with your doctor's prescription.

Mefoxin indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Mefoxin, supplied as a premixed solution in plastic containers, is intended for intravenous use only.

Treatment

Mefoxin is indicated for the treatment of serious infections caused by susceptible strains of the designated microorganisms in the diseases listed below.

Appropriate culture and susceptibility studies should be performed to determine the susceptibility of the causative organisms to Mefoxin. Therapy may be started while awaiting the results of these studies.

In randomized comparative studies, Mefoxin and cephalothin were comparably safe and effective in the management of infections caused by gram-positive cocci and gram-negative rods susceptible to the cephalosporins. Mefoxin has a high degree of stability in the presence of bacterial beta-lactamases, both penicillinases and cephalosporinases.

Many infections caused by aerobic and anaerobic gram-negative bacteria resistant to some cephalosporins respond to Mefoxin. Similarly, many infections caused by aerobic and anaerobic bacteria resistant to some penicillin antibiotics (ampicillin, carbenicillin, penicillin G) respond to treatment with Mefoxin. Many infections caused by mixtures of susceptible aerobic and anaerobic bacteria respond to treatment with Mefoxin.

Prevention

Mefoxin is indicated for the prophylaxis of infection in patients undergoing uncontaminated gastrointestinal surgery, vaginal hysterectomy, abdominal hysterectomy, or cesarean section.

If there are signs of infection, specimens for culture should be obtained for identification of the causative organism so that appropriate treatment may be instituted.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Mefoxin and other antibacterial drugs, Mefoxin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

How should I use Mefoxin?

Use Mefoxin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Mefoxin.

Uses of Mefoxin in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Bacteremia/sepsis: Treatment of bacteremia/sepsis caused by Streptococcus pneumoniae, Staphylococcus aureus (including penicillinase-producing strains), Escherichia coli, Klebsiella species, and Bacteroides species including B. fragilis.

Bone and joint infections: Treatment of bone and joint infections caused by S. aureus (including penicillinase-producing strains).

Gynecological infections: Treatment of endometritis, pelvic cellulitis, and pelvic inflammatory disease caused by E. coli, Neisseria gonorrhoeae (including penicillinase-producing strains), Bacteroides species including Bacteroides fragilis, Clostridium species, P. niger, Peptostreptococcus species, and Streptococcus agalactiae.

Limitations of use: Mefoxin does not have activity against Chlamydia trachomatis. When Mefoxin is used to treat pelvic inflammatory disease, add appropriate antichlamydial coverage.

Lower respiratory tract infections: Treatment of pneumonia and lung abscess, caused by S. pneumoniae, other streptococci (excluding enterococci; eg, Enterococcus faecalis [formerly Streptococcus faecalis]), S. aureus (including penicillinase-producing strains), E. coli, Klebsiella species, Haemophilus influenzae, and Bacteroides species.

Septicemia: Treatment of septicemia caused by S. pneumoniae, S. aureus (including penicillinase-producing strains), E. coli, Klebsiella species, and Bacteroides species including B. fragilis.

Skin and skin structure infections: Treatment of skin and skin structure infections caused by S. aureus (including penicillinase-producing strains), Staphylococcus epidermidis, Streptococcus pyogenes and other streptococci (excluding enterococci [eg, E. faecalis] [formerly S. faecalis]), E. coli, Proteus mirabilis, Klebsiella species, Bacteroides species including B. fragilis, Clostridium species, P. niger, and Peptostreptococcus species.

Urinary tract infections: Treatment of UTIs caused by E. coli, Klebsiella species, P. mirabilis, Morganella morganii, Proteus vulgaris, and Providencia species (including Providencia rettgeri).

Off Label Uses

Bite wounds (animal)

Based on the Infectious Diseases Society of America (IDSA) guidelines for the diagnosis and management of skin and soft tissue infections (SSTI), Mefoxin is an effective and recommended option for treatment of animal bites.

Nontuberculous mycobacterial disease

Based on the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) guideline for the diagnosis, treatment, and prevention of nontuberculous mycobacterial disease, Mefoxin, as part of a multidrug regimen, is an effective and recommended option for the treatment of susceptible nontuberculous mycobacterial disease.

Mefoxin description

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The drug chamber is filled with Mefoxin USP, a semisynthetic, broad-spectrum cepha antibiotic sealed under nitrogen for IV administration. It is derived from cephamycin C, which is produced by Streptomyces lactamdurans. It is sodium (6R,7S)-3-(hydroxymethyl)-7-methoxy-8-oxo-7-[2-(2-thienyl)acetamido]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate carbamate (ester). The empirical formula is C16H16N3Na07S2 and the molecular weight is 449.44.

Mefoxin contains approximately 53.8 mg (2.3 mEq) of sodium per gram of Mefoxin activity.

B Braun Mefoxin is supplied as a sterile, nonpyrogenic, single use packaged combination of Mefoxin (filled using Mefoxin USP) and dextrose injection (diluent). After reconstitution, each 50 mL contains Cefoxitin equivalent to either 1 or 2 g Mefoxin. The diluent chamber contains dextrose injection. The concentration of dextrose hydrous USP in water for injection USP has been adjusted to render the reconstituted drug product iso-osmotic. Dextrose hydrous USP has been added to adjust the osmolality to approximately 290 mOsmol/kg [approximately 2 g (4% w/v) and 1.1 g (2.2% w/v) to the 1 g and 2 g doses, respectively]. Dextrose injection is sterile, nonpyrogenic and contains no bacteriostatic and antimicrobial agents.

The molecular weight of dextrose hydrous USP is 198.17.

After removing the peelable foil strip, activating the seals, and thoroughly mixing, the reconstituted drug product is intended for single IV use. When reconstituted according to instructions in the product labeling, the approximate osmolality of the reconstituted solution of B Braun Mefoxin is approximately 290 mOsmol/kg. After reconstitution, the pH is approximately 6.5. Solutions of B Braun Mefoxin range from colorless to light amber.

The Duplex container is latex-free, PVC-free and Di(2-ethylhexyl)phthalate (DEHP)-free.

The Duplex dual chamber container is made from a specially formulated material. The product (diluent and drug) contact layer is a mixture of thermoplastic rubber and a polypropylene ethylene copolymer that contains no plasticizers. The safety of the container system is supported by USP biological evaluation procedures.

Mefoxin dosage

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Intended for IV use only.

Treatment: Adults: Usual Dosage Range: 1-2 g every 6-8 hrs. Dosage should be determined by susceptibility of the causative organisms, severity of infection, and the condition of the patient.

If C. trachomatis is a suspected pathogen, appropriate anti-chlamydial coverage should be added, because Mefoxin has no activity against this organism.

B Braun Mefoxin may be used in patients with reduced renal function with the following dosage adjustments:

Adults with Renal Insufficiency: Initial Loading Dose: 1-2 g may be given. After a loading dose, the recommendations for maintenance dosage may be used as a guide.

When only the serum creatinine level is available, the following formula (based on sex, weight and age of the patient) may be used to convert this value into creatinine clearance. The serum creatinine should represent a steady state of renal function.

Patients Undergoing Hemodialysis: Loading Dose: 1-2 g should be given after each hemodialysis and the maintenance dose should be given as indicated in Table 10.

Antibiotic therapy for group A β-hemolytic streptococcal infections should be maintained for at least 10 days to guard against the risk of rheumatic fever or glomerulonephritis. In staphylococcal and other infections involving a collection of pus, surgical drainage should be carried out where indicated.

Pediatric Patients ≥3 months: Recommended

Dosage: 80-160 mg/kg of body weight/day divided into 4-6 equal doses. The higher dosages should be used for more severe or serious infections. The total daily dosage should not exceed 12 g.

At this time, no recommendation is made for pediatric patients from birth to 3 months.

In pediatric patients with renal insufficiency, the dosage and frequency of dosage should be modified consistent with the recommendations for adults.

Prevention: Effective prophylactic use depends on the time of administration. B Braun Mefoxin usually should be given ½-1 hr before the operation, which is sufficient time to achieve effective levels in the wound during the procedure. Prophylactic administration should usually be stopped within 24 hrs since continuing administration of any antibiotic increases the possibility of adverse reactions but in the majority of surgical procedures, does not reduce the incidence of subsequent infection.

For prophylactic use in uncontaminated gastrointestinal surgery, vaginal or abdominal hysterectomy, the following doses are recommended:

Adults: 2 g administered IV just prior to surgery (approximately ½-1 hr before the initial incision) followed by 2 g every 6 hrs after the 1st dose for no more than 24 hrs.

Pediatric Patients ≥3 months: 30-40 mg/kg doses may be given at the times designated as in adults.

Cesarean Section Patients: For patients undergoing cesarean section, either a single 2 g dose administered IV as soon as the umbilical cord is clamped or a 3-dose regimen consisting of 2-g given IV as soon as the umbilical cord is clamped followed by 2 g, 4 and 8 hrs after the initial dose is recommended.

Administration: The IV route is preferable for patients with bacteremia, bacterial septicemia, or other severe or life-threatening infections, or for patients who may be poor risks because of lowered resistance resulting from such debilitating conditions as malnutrition, trauma, surgery, diabetes, heart failure or malignancy, particularly if shock is present or impending.

B Braun Mefoxin may be administered through the tubing system by which the patient may be receiving other IV solutions. However, during infusion of the solution containing B Braun Mefoxin, it is advisable to temporarily discontinue administration of any other solutions at the same site.

Solutions of B Braun Mefoxin, like those of most β-lactam antibiotics, should not be added to aminoglycoside solutions (eg, gentamicin sulfate, tobramycin sulfate, amikacin sulfate) because of potential interaction.

However, B Braun Mefoxin and aminoglycosides may be administered separately to the same patient.

Mefoxin interactions

See also:
What other drugs will affect Mefoxin?

Increased nephrotoxicity has been reported following concomitant administration of cephalosporins and aminoglycoside antibiotics.

Drug/Laboratory Test Interactions

As with cephalothin, high concentrations of Mefoxin (>100 micrograms/mL) may interfere with measurement of serum and urine creatinine levels by the Jaffé reaction, and produce false increases of modest degree in the levels of creatinine reported. Serum samples from patients treated with Mefoxin should not be analyzed for creatinine if withdrawn within 2 hours of drug administration.

High concentrations of Mefoxin in the urine may interfere with measurement of urinary 17-hydroxy-corticosteroids by the Porter-Silber reaction, and produce false increases of modest degree in the levels reported.

A false-positive reaction for glucose in the urine may occur. This has been observed with CLINITEST reagent tablets.

† Registered trademark of Ames Company, Division of Miles Laboratories, Inc.

Mefoxin side effects

See also:
What are the possible side effects of Mefoxin?

Mefoxin is generally well tolerated. The most common adverse reactions have been local reactions following IV injection. Other adverse reactions have been encountered infrequently.

Local Reactions: Thrombophlebitis has occurred with IV administration.

Allergic Reactions: Rash (including exfoliative dermatitis and toxic epidermal necrolysis), urticaria, flushing, pruritus, eosinophilia, fever, dyspnea, and other allergic reactions including anaphylaxis, interstitial nephritis and angioedema have been noted.

Cardiovascular: Hypotension.

Gastrointestinal: Diarrhea, including documented pseudomembranous colitis which can appear during or after antibiotic treatment. Nausea and vomiting have been reported rarely.

Neuromuscular: Possible exacerbation of myasthenia gravis.

Blood: Eosinophilia, leukopenia including granulocytopenia, neutropenia, anemia including hemolytic anemia, thrombocytopenia and bone marrow depression. A positive direct Coombs' test may develop in some individuals, especially those with azotemia.

Liver Function: Transient elevation in SGOT, SGPT, serum lactate dehydrogenase and serum alkaline phosphatase, and jaundice have been reported.

Renal Function: Elevations in serum creatinine and/or blood urea nitrogen levels have been observed. As with the cephalosporins, acute renal failure has been reported rarely. The role of Mefoxin in changes in renal function tests is difficult to assess, since factors predisposing to prerenal azotemia or to impaired renal function usually have been present.

In addition to the adverse reactions listed previously which have been observed in patients treated with Mefoxin, the following adverse reactions and altered laboratory test results have been reported for cephalosporin class antibiotics: Urticaria, erythema multiforme, Stevens-Johnson syndrome, serum sickness-like reactions, abdominal pain, colitis, renal dysfunction, toxic nephropathy, false-positive test for urinary glucose, hepatic dysfunction including cholestasis, elevated bilirubin, aplastic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, agranulocytosis, superinfection, vaginitis including vaginal candidiasis.

Several cephalosporins have been implicated in triggering seizures, particularly in patients with renal impairment when the dosage was not reduced. If seizures associated with drug therapy occur, B Braun Mefoxin should be discontinued. Anticonvulsant therapy can be given if clinically indicated.

Mefoxin contraindications

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What is the most important information I should know about Mefoxin?

Do not use this medication if you are allergic to Mefoxin, or to similar antibiotics, such as Ceftin, Cefzil, Keflex, Omnicef, and others.

Before using this medication, tell your doctor if you are allergic to any drugs (especially penicillin). Also tell your doctor if you have liver or kidney disease, diabetes, heart failure, cancer, a stomach or intestinal disorder, or if you are malnourished.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Mefoxin will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

This medication can cause you to have unusual results with certain lab tests, including tests to check for glucose (sugar) in the urine. Tell any doctor who treats you that you are using Mefoxin.



Active ingredient matches for Mefoxin:

Cefoxitin in Argentina, Bahrain, Cyprus, Egypt, Guyana, Iran, Iraq, Ireland, Italy, Jordan, Kuwait, Lebanon, Luxembourg, Oman, Qatar, Saudi Arabia, Sudan, Syria, Taiwan, United Arab Emirates, United States, Yemen.

Cefoxitin sodium in United States.

Cefuroxime

Cefoxitin sodium 1g in 50mL


Unit description / dosage (Manufacturer)Price, USD
Injectable; Injection; Cefoxitin Sodium 1 g
Injectable; Injection; Cefoxitin Sodium 2 g
Injectable; Injection; Cefoxitin Sodium 10 g
Mefoxin injection, solution 1 g/50mL (Bioniche Pharma USA LLC (US))
Mefoxin injection, solution 2 g/50mL (Bioniche Pharma USA LLC (US))

List of Mefoxin substitutes (brand and generic names):

Injectable; Injection; Cefoxitin Sodium 20 mg / ml
Injectable; Injection; Cefoxitin Sodium 40 mg / ml
Injectable; Injection; Cefoxitin Sodium 20 mg / ml
Injectable; Injection; Cefoxitin Sodium 40 mg / ml
Injectable; Injection; Cefoxitin Sodium 20 mg / ml
Injectable; Injection; Cefoxitin Sodium 40 mg / ml
Injectable; Injection; Cefoxitin Sodium 1 g (Merck)
Injectable; Injection; Cefoxitin Sodium 2 g (Merck)
Mefurox tab 500 mg 24's (JF Draf)
Menimycin 750 mg x 10's
Menimycin 750 mg x 10 Bottle
Merocef 1 g x 1's (Gokul (Jantec))$ 43.40
Mextil 250 mg x 2 Blister x 10 Tablet
MIC SEF 500MG TABLET 1 strip / 10 tablets each (Alde Medi Impex Ltd)$ 6.34
Microcefe 500 mg x 10 Tablet
MILCEF Capsule/ Tablet / 250mg / 4 units (Comed)$ 0.86
MILCEF Capsule/ Tablet / 500mg / 4 units (Comed)$ 1.59
MILCEF Capsule/ Tablet / 125mg / 4 units (Comed)$ 1.11
Milcef 125mg TAB / 20 (Comed)$ 5.56
Milcef 250mg TAB / 20 (Comed)$ 6.74
Milcef 500mg TAB / 20 (Comed)$ 11.79
Milcef 750mg INJ / VIAL (Comed)
125 mg x 20's (Comed)$ 5.56
250 mg x 20's (Comed)$ 6.74
500 mg x 20's (Comed)$ 11.79
750 mg x 1's (Comed)
MILCEF 1.5GM INJECTION 1 vial / 1 ML injection each (Comed)$ 2.84
MILCEF 125MG TABLET 1 strip / 4 tablets each (Comed)$ 1.11
MILCEF 250MG TABLET 1 strip / 4 tablets each (Comed)$ 1.90
MILCEF 250MG TABLET 1 strip / 10 tablets each (Comed)$ 2.10
MILCEF 500MG TABLET 1 strip / 4 tablets each (Comed)$ 3.61
MILCEF 500MG TABLET 1 strip / 10 tablets each (Comed)$ 3.97
MILCEF 750MG INJECTION 1 vial / 15 ML injection each (Comed)$ 1.59
MILCEF tab 125 mg x 10's (Comed)$ 2.78
MILCEF tab 250 mg x 10's (Comed)$ 3.37
MILCEF tab 500 mg x 10's (Comed)$ 5.90

References

  1. PubChem. "cefuroxime". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  2. PubChem. "cefoxitin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "cefoxitin". http://www.drugbank.ca/drugs/DB01331 (accessed September 17, 2018).

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