Your doctor may monitor specific events, such as bleeding, while taking cefoxitin. Two such minor interactions occur between cefoxitin and heparin as well as genistein. Pharmacodynamic and pharmacokinetic data
Pharmocokinetic and pharmacodynamic data for cefoxitin are, as of 2013, considered limited and outdated. A few relatively recent studies have attempted to remedy that. One such study was by the Hôpitaux de Paris in collaboration with the French Ministry of Health. However, while the clinical trials were completed in 2015, no study data have been published. The expected results from using cefoxitin over carbapenems, another type of antibiotic with a wider bacterial spectrum, included effective treatment of E. coli produce extended spectrum beta-lactamase, less selective pressure on the GI tract which better maintains balanced flora, and a lower treatment cost.This followed a 2012 French study on the same E. coli strain with CTX-M-15 extended release beta-lactamase. Lepeule et al. determined that in mice, the ideal pharmacodynamic target of fT>MIC=33%, where MIC is the minimum inhibitory concentration, was obtained with 200 mg/kg every four hours. The fT>MIC (%) was increased by 11% when the administration frequency was increased from every four hours to every three hours. This implied that increasing the frequency might yield similar results in humans. The study also found no significant difference between the effectiveness of carbapenems and cefoxitin and suggested that cefoxitin can be used as an alternative treatment for CTX-M producing E. coli to carbapenems such as imipenem and ertapenem. References
External links
"Cefoxitin". Drug Information Portal. U.S. National Library of Medicine. "Cefoxitin sodium".
By binding to PBPs, cefoxitin prevents the PBPs from forming the cross-linkages between the peptidoglycan layers that make up the bacterial cell wall, thereby interfering with cell wall synthesis. It is a strong beta-lactamase inducer, as are certain other antibiotics (such as imipenem). However, cefoxitin is a better substrate than imipenem for beta-lactamases. Microbiological resistance
In the presence of cefoxitin, bacteria that make beta-lactamases will increase their production and secretion to cleave the beta lactam ring. As a cephamycin, cefoxitin is highly resistant to hydrolysis by some beta-lactamases, in part due to the presence of the 7-alpha-methoxy functional group (see skeletal formula above).Another more efficient form of resistance to cefoxitin is provided by the mecA gene in bacteria. This gene codes for an alternative penicillin binding protein, PBP2a. This PBP has a lower binding affinity for penicillin-based antibiotics such as cefoxitin and will continue to cross-link the peptidoglycan layers of the cell wall even in the presence of the beta-lactam antibiotics. MRSA, or methicillin-resistant Staphylococcus aureus is a strain that has acquired resistance to cefoxitin via this gene. For the purposes of detecting bacterial strains with the mecC gene, which like mecA codes for a different PBP, cefoxitin is more reliable than oxacillin because mecC does not correlate as strongly with oxacillin resistance. Spectrum of bacterial susceptibility
Cefoxitins spectrum of in vitro antimicrobial activity includes a broad range of gram-negative and gram-positive bacteria, including anaerobes. It is inactive against most strains of Pseudomonas aeruginosa and many strains of Enterobacter cloacae.