cefoxitin
Sources réglementaires consultées
Indications approuvées
- Infections urinaires compliquées et pyélonéphrite chez l’adulte et l’adolescent ; peut être utile dans certaines infections intra-abdominales et gynécologiques.
Contre-indications
Absolues
- Hypersensibilité à la céfoxitine ou aux céphalosporines, ou antécédent de réaction immédiate et sévère à une autre bêta-lactamine.
Mises en garde cliniques
- Mise en garde majeure · Il peut provoquer une hypersensibilité sévère ou une anaphylaxie. Rechercher tout antécédent de réaction immédiate aux bêta-lactamines avant l’emploi et arrêter en cas de réaction allergique. — CIMA/AEMPS, ficha técnica 84251
- Mise en garde majeure · Il peut provoquer une diarrhée associée à Clostridioides difficile pendant ou après le traitement ; évaluer toute diarrhée importante et éviter les antipéristaltiques si une colite est suspectée. — CIMA/AEMPS, ficha técnica 84251
- Mise en garde majeure · L’accumulation, notamment en cas d’insuffisance rénale, peut provoquer une encéphalopathie et des convulsions ; ajuster le schéma et surveiller l’état neurologique. — CIMA/AEMPS, ficha técnica 84251
Interactions médicamenteuses
- SévèreAnticoagulants oraux
Mécanisme: L’antibiotique et l’infection peuvent augmenter l’INR ou le risque hémorragique.
Recommandation: Surveiller l’INR et les signes de saignement pendant et peu après le traitement.
CIMA/AEMPS, ficha técnica 84251
- ModéréeProbénécide
Mécanisme: Il réduit la sécrétion tubulaire rénale et peut augmenter et prolonger l’exposition à l’antibiotique.
Recommandation: Éviter l’association sauf indication délibérée et surveiller la toxicité.
CIMA/AEMPS, ficha técnica 84251
- SévèreAminosides et autres médicaments néphrotoxiques
Mécanisme: L’association peut augmenter la néphrotoxicité.
Recommandation: Éviter l’association si possible et surveiller la fonction rénale.
CIMA/AEMPS, ficha técnica 84251
Effets indésirables
Communs (≥1%)
Nausées, diarrhée et éruption cutanée
Rares mais graves
Anaphylaxie, colite à C. difficile et cytopénies sévères
Grossesse et allaitement
Utiliser pendant la grossesse uniquement en cas d’indication claire. De faibles quantités passent dans le lait ; surveiller diarrhée, candidose ou sensibilisation chez le nourrisson et réévaluer la poursuite selon le produit.
Bibliographie récente (PubMed)
The stability of gut microbiota is essential for the host's health. Parabacteroides spp., core members of the human gut microbiota, have an average abundance of 1.27% in humans of 12 populations. Parabacteroides have recently been reported to have a close relationship with host health (e.g. metabolic syndrome, inflammatory bowel disease and obesity). Parabacteroides have the physiological characteristics of carbohydrate metabolism and secreting short chain fatty acids. However, antimicrobial resistance of Parabacteroides to antibiotics (such as clindamycin, moxifloxacin and cefoxitin) should not be ignored. In this review, we primarily focus on Parabacteroides distasonis, Parabacteroides goldsteinii, Parabacteroides johnsonii and Parabacteroides merdae and discuss their relationships with host disease, diet and the prevention or induction of diseases. Pa. distasonis and Pa. goldsteinii may be viewed as potential next generation probiotic candidates due to their protective effects on inflammation and obesity in mice. We also discuss the potential therapeutic application of Parabacteroides spp. in maintaining host-intestine homeostasis. The cephalosporins are a family of bactericidal antibiotics structurally related to penicillin which were first derived from the fungus, Cephalosporum acremonium. Their basic structure is similar to penicillin with a thiazolidine and beta-lactam ring, which has a variable side chain. Cephalosporins bind to the penicillin-binding proteins on bacteria and inhibit synthesis of the bacterial cell wall, causing cell lysis particularly in rapidly growing organisms. Their differences in activity relate to the range of penicillin-binding proteins that they inhibit. They have a broader activity than the standard penicillins, but are also sensitive to some extent to beta-lactamase. Five generations of cephalosporins have been developed with varying antibacterial activity. Cephalosporins are indicated for infections with susceptible organisms of
Surgical antibiotic prophylaxis is an important measure to prevent postoperative surgical site infections. Current guideline recommendations do not treat obesity specifically, although it can affect pharmacokinetics and pharmacodynamics. The objective of this review was to synthesize current evidence on the need for obesity-related dosing adjustments in surgical antibiotic prophylaxis. MEDLINE and Cochrane Library were searched for studies investigating antibiotic prophylaxis dosing in surgical patients with obesity. Outcomes of interest were pharmacokinetic parameters such as plasma and interstitial fluid concentrations, area under the concentration time curve in plasma and in interstitial fluid, and other pharmacokinetic measures. Thirty studies investigating cefazolin, cefoxitin, cefuroxime, piperacillin/tazobactam, meropenem, ertapenem, metronidazole, vancomycin, ciprofloxacin, and gentamicin were included in this analysis. Except for metronidazole, cefoxitin, and gentamicin, there is currently no evidence suggesting the need for dosing adjustments.
The incidence of postendoscopic retrograde cholangiopancreatography (ERCP) infections is reported to be up to 18% in patients with biliary obstruction. Antibiotic prophylaxis may reduce the risk of infectious complications after ERCP; however, the clinical value of prophylactic antibiotics in ERCP remains controversial. We conducted a double-blind, placebo-controlled, randomized trial to investigate whether the use of prophylactic antibiotics would reduce infectious complications after ERCP in patients with biliary obstruction. We randomly assigned patients in a 1:1 ratio to receive either a single dose of 1 g intravenous cefoxitin or normal saline as a placebo 30 minutes before undergoing ERCP. The primary outcome was the incidence of infectious complications after ERCP. We enrolled 378 patients, and 189 patients were assigned to each group. The risk of infectious complications after ERCP was 2.8% (5 of 176 patients) in the antibiotic prophylaxis group and 9.8% (17 of 173 patients) in the placebo group (risk ratio, 0.29; 95% confidence interval [CI], 0.11-0.74, P = 0.0073). The incidence rates of bacteremia were 2.3% (4 of 176 patients) and 6.4% (11 of 173 patients), respectively (risk ratio, 0.36; 95% CI, 0.12-1.04; P = 0.0599). The incidence rate of cholangitis was 1.7% (3 of 176 patients) in the antibiotic prophylaxis group and 6.4% (11 of 173 patients) in the placebo group (risk ratio, 0.27; 95% CI, 0.08-0.87; P = 0.0267). Antibiotic prophylaxis before ERCP in patients with biliary obstruction resulted in a significantly lower risk of infectious complications, especially cholangitis, than placebo ( ClinicalTrials.gov trial number NCT02958059).