Cefoxitin Adverse Reactions
- abdominal pain
- agranulocytosis
- anaphylactoid reactions
- anemia
- angioedema
- aplastic anemia
- azotemia
- bleeding
- candidiasis
- cholestasis
- colitis
- diarrhea
- dyspnea
- elevated hepatic enzymes
- eosinophilia
- erythema multiforme
- exfoliative dermatitis
- fever
- flushing
- hemolytic anemia
- hyperbilirubinemia
- hypotension
- injection site reaction
- interstitial nephritis
- jaundice
- leukopenia
- maculopapular rash
- nausea/vomiting
- neutropenia
- pancytopenia
- phlebitis
- pruritus
- pseudomembranous colitis
- seizures
- serum sickness
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vaginitis
Cefoxitin Adverse Reactions
Cefoxitin is generally well tolerated. The most common adverse reaction has been a local injection site reaction following parenteral administration. Thrombo-phlebitis is the most common local reaction reported.
Cefoxitin has been associated with elevations in serum creatinine and/or blood urea nitrogen (azotemia). As with other cephalosporins, acute renal failure (unspecified) has been rarely reported. Assessment of the role of cefoxitin in changes in renal function is difficult because factors predisposing to prerenal azotemia or to impaired renal function have been present. Renal impairment, toxic nephropathy, and false-positive test for urinary glucose have been reported with cephalosporin antibiotics. Patients with preexisting renal dysfunction, patients taking other nephrotoxic drugs, and patients over 50 years of age are more susceptible.
Diarrhea, including documented cases of pseudomembranous colitis have been reported with cefoxitin. Pseudomembranous colitis can occur during use of or following discontinuation of cefoxitin therapy. Cephalosporins are more often associated with pseudomembranous colitis than are other antibiotic types.[1404] [6661] Nausea/vomiting has been reported rarely. Abdominal pain, colitis, elevated bilirubin (hyperbilirubinemia), elevated hepatic enzymes, hepatic impairment including cholestasis, and jaundice has been reported with other cephalosporins.
Allergic reactions have been reported infrequently with cefoxitin. These reactions include dyspnea, eosinophilia, fever, flushing, maculopapular rash (including exfoliative dermatitis and toxic epidermal necrolysis), pruritus, urticaria, and other allergic reactions including anaphylactoid reactions, interstitial nephritis, and angioedema. Erythema multiforme, Stevens-Johnson syndrome, and serum sickness-like reactions have been reported with other cephalosporin antibiotics.
Hematologic adverse reactions have been reported infrequently with cefoxitin. Anemia (including hemolytic anemia, thrombocytopenia, and bone marrow depression), eosinophilia, leukopenia (including granulocytopenia), neutropenia, and thrombocytopenia have been reported. A positive direct Coombs test may develop in some patients, especially those with azotemia. Agranulocytosis, aplastic anemia, bleeding (hemorrhage), pancytopenia, and prolonged prothrombin time have been reported during therapy with other cephalosporin antibiotics.
Cefoxitin may possibly cause an exacerbation of myasthenia gravis.
Several cephalosporin antibiotics have been associated with seizures, particularly in patients with renal impairment when the dosage was not reduced. If seizures occur during cefoxitin therapy, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated.
Hypotension has been reported infrequently with cefoxitin therapy.
Superinfection and vaginitis including vaginal candidiasis have been reported with cephalosporin antibiotics.
[ Last revised: 9/22/2004 5:38:00 PM ]
References
. Kelly CP, Pothoulakis C, LaMont JT. Clostridium difficile colitis. N Engl J Med 1994;330:257 - 62.
. Mefoxin® (cefoxitin injection) package insert. Whitehouse Station, NJ: Merck & Co., Inc.; 2003 Aug.
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