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ARTICLE |

Cefoxitin Falsely Elevates Creatinine Levels FREE

Alfred J. Saah, MD; Thomas R. Koch, PhD; George L. Drusano, MD
[+] Author Affiliations

Reprint requests to Division of Infectious Diseases, University of Maryland School of Medicine and Hospital, 29 S Greene St, Baltimore, MD 21201 (Dr Drusano).


JAMA. 1982;247(2):205-206. doi:10.1001/jama.1982.03320270043022
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Cefoxitin sodium has been found to act like creatinine in assays for creatinine used by many hospitals. Our in vitro results show that cefoxitin causes an apparent rise in the serum creatinine level; the magnitude of the increase depends on the assay method and the concentration of cefoxitin. Results varied from 1.5 to more than 8.5 times the normal serum creatinine level. Published data from studies of human volunteers show the same effect. In patients with normal renal function, the serum creatinine test is reliable two to four hours following cefoxitin infusion and in mild to moderate renal failure (glomerular filtration rate greater than 30 mL/min), six to eight hours. In severe renal failure, the serum creatinine determination is unreliable. Measurement of urinary creatinine employs similar assays, thus making estimation of creatinine clearance unreliable when the patient is receiving cefoxitin.

(JAMA 1982;247:205-206)

REFERENCES

Swain RR, Briggs SL:  Positive interference with the Jaffe reaction by cephalosporin antibiotics . Clin Chem 1977;;23:1340-1342.
Faulkner WR, King JW:  Renal function , in Tietz NW (ed): Fundamentals of Clinical Chemistry , ed 2. Philadelphia, WB Saunders Co, 1976;, pp 994-999.
Hicks JM, Isosefsohn M, Lewis SA:  Evaluation of the Beckman Creatinine Analyzer . Clin Chem 1970;;25:1005-1008.
Fabiny D, Ertingshausen G:  Automated reaction rate method for determination of serum creatinine with the Centri-Chem . Clin Chem 1971;;17:696-700.
Durham SR, Bignell AHC, Wise R:  Interference of cefoxitin in the creatinine estimation and its clinical relevance . J Clin Pathol 1979;;32:1148-1151.
Sawchuck RJ, Zaske DE, Cipolle RJ, et al:  Kinetic model for gentamicin dosing with the use of individual patient parameters . Clin Pharmacol Ther 1977;;21:362-369.

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Swain RR, Briggs SL:  Positive interference with the Jaffe reaction by cephalosporin antibiotics . Clin Chem 1977;;23:1340-1342.
Faulkner WR, King JW:  Renal function , in Tietz NW (ed): Fundamentals of Clinical Chemistry , ed 2. Philadelphia, WB Saunders Co, 1976;, pp 994-999.
Hicks JM, Isosefsohn M, Lewis SA:  Evaluation of the Beckman Creatinine Analyzer . Clin Chem 1970;;25:1005-1008.
Fabiny D, Ertingshausen G:  Automated reaction rate method for determination of serum creatinine with the Centri-Chem . Clin Chem 1971;;17:696-700.
Durham SR, Bignell AHC, Wise R:  Interference of cefoxitin in the creatinine estimation and its clinical relevance . J Clin Pathol 1979;;32:1148-1151.
Sawchuck RJ, Zaske DE, Cipolle RJ, et al:  Kinetic model for gentamicin dosing with the use of individual patient parameters . Clin Pharmacol Ther 1977;;21:362-369.
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