Treatment of septicemic patients with cefoxitin: pharmacokinetics in renal insufficiency

Experience with cefoxitin in the treatment of septicemia of diverse etiologies in 11 patients is reviewed. Results of a small study of the pharmacokinetics of cefoxitin in patients with renal insufficiency, which was used as a guideline for determining the dosage of cefoxitin for severely ill patients with renal insufficiency, are included. In addition, a summary of data on file at Merck Sharp and Dohme Research Laboratories (Rahway, New Jersey) that concern 135 bacteremic patients who were treated with cefoxitin and evaluated is presented. Although information derived from septicemic patients is among the most difficult to interpret in regard to the efficacy of an investigational antibiotic, both our experience and the summary of data confirm that cefoxitin is a potent antibiotic suitable for use in septicemic patients when the etiologic agent is susceptible; the data also demonstrate that cefoxitin has a significantly expanded spectrum of activity as compared with that of cephalothin.