Cefoxitin

Susceptible infections: IV: 1 to 2 g every 6 to 8 hours (IM injection is painful); up to 12 g daily Bite wounds (animal) (off-label use): IV: 1 g every 6 to 8 hours (IDSA [Stevens 2014]) Gas gangrene: IV: 2 g every 4 hours or 3 g every 6 hours (maximum daily dosage: 12 g daily) Intra-abdominal infection, complicated, community acquired, mild-to-moderate (Solomkin 2010): IV: 2 g every 6 hours for 4 to 7 days (provided source controlled) Moderately severe or severe infections: IV: 1 g every 4 hours or 2 g every 6 to 8 hours (maximum daily dosage: 8 g daily) Mycobacterium abscessus, not MTB or MAI (off-label use; Griffith 2007): IV: 12 g daily in divided doses with concomitant amikacin for ≥14 days Pelvic inflammatory disease (CDC [Workowski 2015]): Inpatients: IV: 2 g every 6 hours plus doxycycline for at least 24 to 48 hours after clinical improvement, followed by oral doxycycline to complete 14 days Outpatients: IM: 2 g as a single dose plus oral probenecid, followed by oral doxycycline (with or without concomitant metronidazole) for 14 days Surgical (perioperative) prophylaxis: Manufacturer's labeling (procedures other than Cesarian section): IV: 2 g 30 to 60 minutes prior to surgical incision, followed by 2 g every 6 hours for no more than 24 hours after surgery depending on the procedure Cesarean section: IV: 2 g as soon as umbilical cord is clamped as a single dose or 2 g as soon as umbilical cord is clamped followed by 2 g at 4 and 8 hours after the initial dose. Alternative recommendations: 2 g within 60 minutes prior to surgical incision. Doses may be repeated in 2 hours if procedure is lengthy or if there is excessive blood loss (Bratzler 2013). Uncomplicated cutaneous, urinary tract, lung infections: IV: 1 g every 6–8 hours (maximum daily dosage: 4 g daily)