How to Administer Cefoxitin IV?

October 11, 2025 •

3 min read

Following an intravenous dose of 1 gram, cefoxitin serum concentrations can reach 110 mcg/mL at 5 minutes, underscoring the rapid effect of proper IV administration. Administering cefoxitin IV requires careful preparation and adherence to established protocols to ensure patient safety and therapeutic efficacy. This guide outlines the essential steps for healthcare professionals.

Quick Summary

This guide provides detailed instructions on how to administer cefoxitin intravenously, covering preparation of the sterile powder, choosing appropriate administration methods like IV push or intermittent infusion, and understanding correct administration and safety measures. The information is critical for healthcare professionals ensuring safe and effective patient treatment.

Key Points

Reconstitution is Required: Cefoxitin powder must be reconstituted with a compatible sterile diluent like Sterile Water for Injection or 0.9% Sodium Chloride Injection before IV use.
Choose the Right Method: Cefoxitin can be given as a slow IV push over 3-5 minutes or as an intermittent infusion over approximately 30 minutes, depending on the clinical situation.
Further Dilution for Infusion: For intermittent infusion, the reconstituted solution must be further diluted in a compatible IV fluid such as 5% Dextrose Injection.
Adjust for Renal Impairment: The amount and frequency of cefoxitin administration must be reduced for patients with decreased kidney function to prevent toxicity.
Monitor for Allergies: Cefoxitin is contraindicated in patients with a history of hypersensitivity to cefoxitin, other cephalosporins, or penicillins.
Avoid Aminoglycoside Co-administration: Cefoxitin solutions should not be mixed with or administered concurrently at the same site as aminoglycoside solutions.
Inspect Visually: Always visually inspect the reconstituted solution for particulate matter and discoloration before administration.

Cefoxitin is a semi-synthetic, broad-spectrum cephamycin antibiotic used to treat various bacterial infections and for surgical prophylaxis. IV administration is often used for severe infections or in patients with weakened immune systems. Proper administration technique is vital for effectiveness and to minimize risks like local site reactions.

Preparing Cefoxitin for IV Administration

Cefoxitin is supplied as a sterile powder requiring reconstitution.

Reconstitution Steps

Gather Supplies: Collect the cefoxitin vial, a sterile diluent, syringes, and transfer devices.
Inspect the Vial: Examine the white to off-white powder. Discoloration may occur but doesn't affect potency, but discard if particulate matter is visible.
Choose a Diluent: Compatible options include Sterile Water for Injection, 0.9% Sodium Chloride Injection, or 5% Dextrose Injection. Avoid diluents with benzyl alcohol for infants under 3 months.
Reconstitute: Add the appropriate amount of diluent to the cefoxitin vial based on the package instructions and desired concentration.
Mix Thoroughly: Shake until the powder dissolves and the solution is clear.
Further Dilution (for IV Infusion): For intermittent or continuous infusion, the reconstituted solution is typically further diluted in a compatible IV fluid.

Intravenous Administration Methods

Cefoxitin can be administered via slow IV push or intermittent IV infusion.

Intermittent IV Infusion

This method involves infusing the further-diluted solution over a specified period, often around 30 minutes, and is common for standard administrations. It is recommended to temporarily stop other IV solutions at the same site during infusion.

IV Push (Bolus)

An IV push involves injecting the reconstituted solution over a short period, typically 3 to 5 minutes. This faster method is used in certain situations but requires close monitoring.

Administration Considerations

Administration frequency and volume depend on the patient's condition, the severity of the infection, and renal function. The specific concentration of the reconstituted solution and the amount of further dilution for infusion should follow established protocols and product labeling.

Adults: Administration intervals vary based on the treated condition.
Pediatrics: Administration for children 3 months and older also follows specific guidelines.
Renal Impairment: The amount and frequency of administration must be adjusted based on creatinine clearance to prevent drug accumulation.

Patient Safety and Important Information

Key Safety Considerations for Cefoxitin IV:

Allergy: Contraindicated in patients with hypersensitivity to cefoxitin, penicillins, or other cephalosporins.
Interaction with Aminoglycosides: Administer cefoxitin and aminoglycosides separately; do not mix solutions.
C. difficile Diarrhea: Cefoxitin use can lead to CDAD. Report persistent diarrhea.
Renal Function: High cefoxitin levels, particularly with impaired renal function, can cause seizures. Adjust administration accordingly.
Storage and Stability: Reconstituted solutions have limited stability. Follow specific product guidelines for storage and discard times.
Monitoring: Using cefoxitin for unconfirmed bacterial infections can increase resistance risks. Patient monitoring is crucial.

Comparison of Administration Methods


Feature	Intermittent IV Infusion	IV Push (Bolus)
Typical Duration	Around 30 minutes	3 to 5 minutes
Dilution	Further diluted in a compatible solution	Reconstituted in the amount of diluent specified for the desired concentration
Primary Use Case	Severe infections, routine administration	Expedited administration, certain clinical scenarios
Risk of Local Reaction	Lower risk of thrombophlebitis	Higher risk of thrombophlebitis if administered too quickly
Complexity	More time-intensive, may require infusion pump	Faster, requires close monitoring during administration

Conclusion

Proper cefoxitin IV administration is essential for effective and safe patient care. Key steps include careful preparation and dilution, selecting the appropriate administration method, and monitoring for adverse reactions. Following established protocols and adjusting administration for renal impairment are crucial to minimize risks. Refer to official product inserts and drug monographs for comprehensive information.

This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before administering any medication.

Frequently Asked Questions

Cefoxitin powder can be reconstituted with sterile water for injection, bacteriostatic water for injection, 0.9% sodium chloride injection, or 5% dextrose injection.

For intermittent IV push, the reconstituted solution can be injected over a period of 3 to 5 minutes.

For intermittent IV infusion, cefoxitin is typically administered intravenously over a period of approximately 30 minutes.

Solutions of cefoxitin should not be mixed with or administered concurrently at the same site as aminoglycoside antibiotics (e.g., gentamicin) due to potential interactions. They may be administered separately.

The amount and frequency of administration must be modified based on the patient's creatinine clearance to prevent drug accumulation and toxicity. Specific guidelines should be followed.

After reconstitution, solutions for IV administration are stable for 6 hours at room temperature or for one week if refrigerated. After further dilution for infusion, stability may extend for additional hours.

Before administration, the reconstituted solution should be visually inspected for particulate matter and discoloration. Discard the solution if it contains particles or if the color is dark brown.