Cefoxitin side effects: what 1,372 FDA adverse event reports show
Drug class
Not stated in label
Who reports
1,372 reports · 88% serious · 126 with death outcome · 56% female
Used for
Treatment Cefoxitin for Injection, USP is indicated for the treatment of serious infections caused by susceptible strains of the designated microorganisms in the diseases listed below. (1) Lower respiratory tract infections , including pneumonia and lu.
What it is
DESCRIPTION Cefoxitin for Injection, USP contains cefoxitin sodium a semi-synthetic, broad-spectrum cephalosporin antibiotic for parenteral administration. It is derived from cephalosporin C, which is produced by Cephalosporium Acremonium .
Boxed warning
PHARMACY BULK PACKAGE – NOT FOR DIRECT INFUSION
Causality screen of the 30 strongest signals
What the badges mean
- Labeled — boxed warning The term (or its clinical synonym) appears in the FDA boxed warning: causality is regulator-recognised and considered serious.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 19 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug resistance | 90 | 53.7 44.0–65.6ROR 57.4 · χ² 4,591 / p <1e-300 | 52.9 EB05 44.4 · IC025 +5.0 3/3 methods agree | Reporting / coding artifact | serious PRR 25.4 · 98% clinician | no trial data cached |
| Drug reaction with eosinophilia and systemic symptoms | 79 | 47.4 38.2–58.7ROR 50.2 · χ² 3,532 / p <1e-300 | 46.7 EB05 38.7 · IC025 +4.8 3/3 methods agree | Not in label — unassessed | serious PRR 30.9 · 96% clinician | no trial data cached |
| Rash maculo-papular | 39 | 26.9 19.8–36.7ROR 27.7 · χ² 947 / p 3e-208 | 26.6 EB05 20.3 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious PRR 18.0 · 100% clinician | no trial data cached |
| Nephropathy toxic | 17 | 23.3 14.5–37.5ROR 23.6 · χ² 341 / p 2e-76 | 22.7 EB05 14.9 · IC025 +3.0 3/3 methods agree | Labeled (related wording) related wording | serious PRR 14.7 | no trial data cached |
| Eosinophilia | 23 | 20.1 13.4–30.2ROR 20.5 · χ² 399 / p 5e-89 | 19.8 EB05 13.8 · IC025 +3.1 3/3 methods agree | Labeled — boxed warning exact term | serious PRR 10.2 · ♀ 32% (drug 56%) · 100% clinician | no trial data cached |
| Anaphylactic shock | 33 | 19.7 14.1–27.6ROR 20.1 · χ² 567 / p 1e-125 | 19.4 EB05 14.4 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious PRR 12.9 · 94% clinician | no trial data cached |
| Circulatory collapse | 21 | 18.8 12.3–28.7ROR 19.0 · χ² 336 / p 3e-75 | 18.4 EB05 12.5 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 12.3 · 100% clinician | no trial data cached |
| Pulmonary mass | 16 | 16.4 10.1–26.8ROR 16.6 · χ² 217 / p 2e-49 | 15.8 EB05 9.7 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious PRR 11.7 | no trial data cached |
| Premature delivery | 16 | 15.3 9.4–24.9ROR 15.5 · χ² 200 / p 1e-45 | 14.5 EB05 8.9 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious PRR 10.2 | no trial data cached |
| Deafness | 26 | 15.2 10.4–22.2ROR 15.4 · χ² 330 / p 4e-74 | 14.8 EB05 10.3 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 10.3 | no trial data cached |
| Hepatocellular injury | 14 | 15.1 8.9–25.4ROR 15.2 · χ² 170 / p 4e-39 | 14.1 EB05 8.1 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious PRR 9.9 | no trial data cached |
| Hyperbilirubinaemia | 10 | 14.8 8.0–27.5ROR 14.9 · χ² 116 / p 3e-27 | 13.1 EB05 6.5 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 8.9 | no trial data cached |
| Tubulointerstitial nephritis | 16 | 13.1 8.0–21.3ROR 13.2 · χ² 166 / p 2e-38 | 12.0 EB05 7.2 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious PRR 8.6 | no trial data cached |
| Bronchospasm (airway tightening) | 11 | 11.7 6.5–21.2ROR 11.8 · χ² 98 / p 3e-23 | 9.9 EB05 5.2 · IC025 +2.0 3/3 methods agree | Not in label — unassessed | serious PRR 8.5 | no trial data cached |
| Neurotoxicity | 13 | 11.4 6.7–19.6ROR 11.5 · χ² 114 / p 8e-27 | 9.9 EB05 5.6 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 7.6 | no trial data cached |
| Anaphylactic reaction (severe allergic reaction) | 39 | 10.9 8.0–14.8ROR 11.1 · χ² 340 / p 4e-76 | 10.4 EB05 7.7 · IC025 +2.7 3/3 methods agree | Labeled — boxed warning synonym match | serious PRR 7.2 · ♀ 77% (drug 56%) · 97% clinician | no trial data cached |
| Pancreatitis acute | 15 | 10.3 6.2–17.0ROR 10.4 · χ² 117 / p 2e-27 | 8.9 EB05 5.3 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 6.7 | no trial data cached |
| Premature baby | 19 | 9.6 6.2–15.0ROR 9.7 · χ² 138 / p 3e-32 | 8.5 EB05 5.5 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 6.4 | no trial data cached |
| Encephalopathy | 15 | 9.4 5.7–15.5ROR 9.4 · χ² 104 / p 1e-24 | 8.0 EB05 4.9 · IC025 +2.0 3/3 methods agree | Not in label — unassessed | serious PRR 6.1 | no trial data cached |
| Blood urea increased | 10 | 9.1 4.9–16.8ROR 9.1 · χ² 64 / p 6e-16 | 7.1 EB05 3.9 · IC025 +1.6 3/3 methods agree | Lab value / disease marker | serious PRR 6.6 | no trial data cached |
| Thrombocytopenia (low platelets) | 62 | 8.5 6.7–10.8ROR 8.9 · χ² 405 / p 3e-90 | 8.2 EB05 6.5 · IC025 +2.6 3/3 methods agree | Labeled — boxed warning exact term | serious PRR 5.6 · ♀ 29% (drug 56%) · 97% clinician | no trial data cached |
| Electrocardiogram qt prolonged | 20 | 8.5 5.5–13.1ROR 8.6 · χ² 125 / p 3e-29 | 7.5 EB05 5.0 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 5.6 · 95% clinician | no trial data cached |
| Cardio-respiratory arrest | 19 | 6.9 4.4–10.8ROR 7.0 · χ² 90 / p 1e-21 | 6.0 EB05 4.0 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 4.5 | no trial data cached |
| Treatment failure | 37 | 6.9 5.0–9.5ROR 7.0 · χ² 181 / p 1e-41 | 6.4 EB05 4.8 · IC025 +2.1 3/3 methods agree | Reporting / coding artifact | serious PRR 7.7 · 97% clinician | no trial data cached |
| Transaminases increased | 10 | 6.9 3.7–12.8ROR 6.9 · χ² 45 / p 1e-11 | 5.4 EB05 3.1 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | serious PRR 4.8 | no trial data cached |
| Hepatitis (liver inflammation) | 11 | 6.6 3.6–11.8ROR 6.6 · χ² 47 / p 5e-12 | 5.3 EB05 3.1 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 4.4 | no trial data cached |
| Renal failure acute | 18 | 6.4 4.0–10.1ROR 6.5 · χ² 77 / p 1e-18 | 5.6 EB05 3.7 · IC025 +1.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 4.2 | no trial data cached |
| Renal injury | 12 | 6.1 3.5–10.7ROR 6.2 · χ² 46 / p 5e-12 | 5.1 EB05 3.1 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 3.7 | no trial data cached |
| Lactic acidosis | 12 | 5.7 3.3–10.0ROR 5.8 · χ² 42 / p 4e-11 | 4.8 EB05 2.9 · IC025 +1.3 3/3 methods agree | Not in label — unassessed | serious PRR 3.7 | no trial data cached |
| Foetal exposure during pregnancy | 19 | 3.6 2.3–5.6ROR 3.6 · χ² 33 / p 5e-9 | 3.3 EB05 2.3 · IC025 +1.0 3/3 methods agree | Reporting / coding artifact | serious PRR 2.4 | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug resistance | 90 | 53.7 44.0–65.6ROR 57.4 · χ² 4,591 / p <1e-300 | 52.9 EB05 44.4 · IC025 +5.0 3/3 methods agree | Reporting / coding artifact | serious PRR 25.4 · 98% clinician | no trial data cached |
| Drug reaction with eosinophilia and systemic symptoms | 79 | 47.4 38.2–58.7ROR 50.2 · χ² 3,532 / p <1e-300 | 46.7 EB05 38.7 · IC025 +4.8 3/3 methods agree | Not in label — unassessed | serious PRR 30.9 · 96% clinician | no trial data cached |
| Thrombocytopenia (low platelets) | 62 | 8.5 6.7–10.8ROR 8.9 · χ² 405 / p 3e-90 | 8.2 EB05 6.5 · IC025 +2.6 3/3 methods agree | Labeled — boxed warning exact term | serious PRR 5.6 · ♀ 29% (drug 56%) · 97% clinician | no trial data cached |
| Anaphylactic reaction (severe allergic reaction) | 39 | 10.9 8.0–14.8ROR 11.1 · χ² 340 / p 4e-76 | 10.4 EB05 7.7 · IC025 +2.7 3/3 methods agree | Labeled — boxed warning synonym match | serious PRR 7.2 · ♀ 77% (drug 56%) · 97% clinician | no trial data cached |
| Rash maculo-papular | 39 | 26.9 19.8–36.7ROR 27.7 · χ² 947 / p 3e-208 | 26.6 EB05 20.3 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious PRR 18.0 · 100% clinician | no trial data cached |
| Treatment failure | 37 | 6.9 5.0–9.5ROR 7.0 · χ² 181 / p 1e-41 | 6.4 EB05 4.8 · IC025 +2.1 3/3 methods agree | Reporting / coding artifact | serious PRR 7.7 · 97% clinician | no trial data cached |
| Anaphylactic shock | 33 | 19.7 14.1–27.6ROR 20.1 · χ² 567 / p 1e-125 | 19.4 EB05 14.4 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious PRR 12.9 · 94% clinician | no trial data cached |
| Deafness | 26 | 15.2 10.4–22.2ROR 15.4 · χ² 330 / p 4e-74 | 14.8 EB05 10.3 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 10.3 | no trial data cached |
| Eosinophilia | 23 | 20.1 13.4–30.2ROR 20.5 · χ² 399 / p 5e-89 | 19.8 EB05 13.8 · IC025 +3.1 3/3 methods agree | Labeled — boxed warning exact term | serious PRR 10.2 · ♀ 32% (drug 56%) · 100% clinician | no trial data cached |
| Circulatory collapse | 21 | 18.8 12.3–28.7ROR 19.0 · χ² 336 / p 3e-75 | 18.4 EB05 12.5 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 12.3 · 100% clinician | no trial data cached |
| Electrocardiogram qt prolonged | 20 | 8.5 5.5–13.1ROR 8.6 · χ² 125 / p 3e-29 | 7.5 EB05 5.0 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 5.6 · 95% clinician | no trial data cached |
| Foetal exposure during pregnancy | 19 | 3.6 2.3–5.6ROR 3.6 · χ² 33 / p 5e-9 | 3.3 EB05 2.3 · IC025 +1.0 3/3 methods agree | Reporting / coding artifact | serious PRR 2.4 | no trial data cached |
| Cardio-respiratory arrest | 19 | 6.9 4.4–10.8ROR 7.0 · χ² 90 / p 1e-21 | 6.0 EB05 4.0 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 4.5 | no trial data cached |
| Premature baby | 19 | 9.6 6.2–15.0ROR 9.7 · χ² 138 / p 3e-32 | 8.5 EB05 5.5 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 6.4 | no trial data cached |
| Renal failure acute | 18 | 6.4 4.0–10.1ROR 6.5 · χ² 77 / p 1e-18 | 5.6 EB05 3.7 · IC025 +1.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 4.2 | no trial data cached |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Drug reaction with eosinophilia and systemic symptoms — n=79, PRR 47.4
- Rash maculo-papular — n=39, PRR 26.9
- Anaphylactic shock — n=33, PRR 19.7
- Circulatory collapse — n=21, PRR 18.8
- Deafness — n=26, PRR 15.2
- Electrocardiogram qt prolonged — n=20, PRR 8.5
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Cefoxitin?
In FDA FAERS, the most frequently co-reported reaction terms for Cefoxitin are drug reaction with eosinophilia and systemic symptoms, thrombocytopenia, anaphylactic reaction, rash maculo-papular, anaphylactic shock, deafness. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Cefoxitin have an FDA boxed warning?
Yes. The current FDA label carries a boxed warning: PHARMACY BULK PACKAGE – NOT FOR DIRECT INFUSION
Do FAERS signals prove that Cefoxitin causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 4c6f7665-204f-6c69-7669-61204d756e6e, effective 20200609; matched on
openfda.generic_name.exact:"CEFOXITIN") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 49 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.