Cefoxitin: A Comprehensive Pharmacological and Clinical Review

1. Introduction to Cefoxitin

1.1. Overview, Classification, and Origin

Cefoxitin is a semi-synthetic, broad-spectrum antibiotic agent intended for parenteral administration, primarily utilized in the management of serious bacterial infections.[1] Within the landscape of antimicrobial agents, Cefoxitin holds a distinct position. It is classified as a cephamycin antibiotic, a subgroup of beta-lactam antibiotics, and is frequently categorized alongside second-generation cephalosporins.[1] This dual classification is not merely academic; it reflects its unique structural attributes and, consequently, its particular spectrum of activity and clinical utility. The "second-generation cephalosporin" grouping generally implies an enhanced spectrum against Gram-negative bacteria compared to first-generation agents, often with some activity against anaerobic bacteria. Cefoxitin aligns with this but its cephamycin nature, specifically the presence of a 7-alpha-methoxy group on its core structure, confers a notable degree of stability against a wide array of bacterial beta-lactamases.[2] This enzymatic stability is a cornerstone of its efficacy against certain challenging pathogens, including many anaerobic organisms, and distinguishes it from many other cephalosporins.