Staphylococci that are resistant to methicillin and oxacillin should also be considered clinically resistant to cefoxitin even if they test susceptible by in vitro methods.Major bacterial strains susceptible to cefoxitin include:
methicillin-susceptible Staphylococcus aureus
Streptococcus sp. E. coli
Salmonella sp. Proteus vulgaris
Flavobacterium sp. Klebsiella sp.Major bacteria resistant to cefoxitin include:
methicillin-resistant Staphylococcus aureus
Enterococci
Listeria monocytogenes
Enterobacter sp. Bacteroides sp. Replacement and substitution
In a 2005 study, Fernandes et al. determined that cefoxitin serves as an appropriate replacement for methicillin in determining if some bacteria display methicillin resistance. Likewise, Funsun et al. found in a 2009 study that cefoxitin disk assays correctly identified all 60 mecA-positive Staphylococcus aureus, or MRSA isolates, to be resistant to cefoxitin.Due, in part, to the unavailability of methicillin in the United States, cefoxitin has replaced methicillin for disk diffusion tests, which determine the sensitivity of a bacterial specimen to a given antibiotic. Cefoxitin also yields more accurate results for disk diffusion tests. Interpretive criteria for determining susceptibility to cefoxitin via disk diffusion are greater than or equal to 22mm resulting in a "susceptible" result for Staphylococcus aureus and greater than or equal to 25mm for coagulase-negative staphylococci to be considered susceptible.The following are susceptibility data for several medically significant microorganisms, measured by minimum inhibitory concentration, which is an alternative, liquid medium test for susceptibility. Escherichia coli: 0.2 μg/ml – 64 μg/ml
Haemophilus influenzae: 0.5 μg/ml – 12.5 μg/ml
Streptococcus pneumoniae: 0.2 μg/ml – 1 μg/ml

Uses in medicine
Cefoxitin is sold in three major IV doses, 1g, 2g, and 10g.
Common side effects include:

local tenderness or pain at the site of injection
skin color change, mild diarrhea
mild nausea
headache
loss of appetite
vaginal discharge and itching
swelling of feet or legs.While cefoxitin has not been associated with alcohol incompatibility like other members of the second generation cephalosporins class, it has been with a higher risk of coagulopathy, a bleeding disorder.This is not a comprehensive list and not intended to provide medical advice. If any of the previous side effects are severe, or if an allergic reaction takes place immediately contact your doctor. Notable drug interactions
Contraindications
A contraindication means that the drug in question should not be used under particular circumstances. For cefoxitin, this includes patients who are hypersensitive to cephalosporin antibiotics.Patients with colitis, kidney disease, or liver disease are also advised not to take cefoxitin. However, some drug databases will considers the diseases means for caution rather than contraindications. Major or Severe
Aside from the above-mentioned contraindications and diseases which require monitoring by a doctor, the live cholera and live typhoid vaccines are known to have a severe interaction with cefoxitin.Individuals on a low sodium diet, undergoing dialysis, or who have experienced seizures, particularly following antibiotic therapy, should also consult their physician prior to taking cefoxitin. Moderate
Only take additional antibiotics, anticoagulants and blood thinners under doctor supervision. Cefoxitin may decrease the effectiveness of hormonal birth control. This increases the risk for pregnancy and a medical consult will help determine whether backup birth control methods should be used. Minor
Minor drug interactions do not usually require a change in treatment.