Cefazolin

Indications
 Parenteral
Susceptible infections
Adult: As sodium: 0.5-1 g deep IM, slow IV Inj over 3-5 min or as iv infusion every 6-12 hr. Max: Up to 6-12 g daily for life-threatening infections.
Child: >1 mth: 25-50 mg/kg daily in 3 or 4 divided doses. Max: Up to 100 mg/kg daily for severe infections.
Renal impairment: Children: CrCl: 40-70 ml/min: 60% of normal daily dose given in 2 divided doses; 20-40 ml/min: 25% of normal daily dose given in 2 divided doses and 5-20 ml/min: 10% of normal daily dose every 24 hr. See table for adult dosing recommendations.
CrCl (ml/min)Dosage Recommendation
35-54Increase dosing interval to at least 8 hr.
11-34Half the usual dose every 12 hr.
≤10Half the usual dose every 18-24 hr.

Parenteral
Prophylaxis of surgical infections
Adult: As sodium: 1 g given 0.5-1 hr before surgery followed by 0.5-1 g during surgery for lengthy procedures; 0.5-1 g every 6-8 hrly may be given after surgery for 24 hr or up to 5 days.
Elderly:
Renal impairment: Children: CrCl: 40-70 ml/min: 60% of normal daily dose given in 2 divided doses; 20-40 ml/min: 25% of normal daily dose given in 2 divided doses and 5-20 ml/min: 10% of normal daily dose every 24 hr. See table for adult dosing recommendations.
CrCl (ml/min)Dosage Recommendation
35-54Increase dosing interval to at least 8 hr.
11-34Half the usual dose every 12 hr.
≤10Half the usual dose every 18-24 hr.


Special Populations: Loading dose for patients with renal impairment: CrCl: >55 mL/min: Usual dose; 35-54 mL/min: Usual dose at 8-hr interval; 11-34 mL/min: ½ the usual dose every 12 hrs; <10 mL/min: ½ the usual dose every 18-24 hrs.
Contraindications
 Hypersensitivity.
Warnings / Precautions
 Impaired renal function; pregnancy, lactation. Consider possibility of pseudomembranous colitis in patients who present with diarrhoea after antimicrobial usage. Risk of seizures in patients on high doses, especially in renally impaired patients. May decrease prothrombin activity; monitor prothrombin time in patients at risk e.g. those on anticoagulant treatment, prolonged antimicrobial treatment or those with renal or hepatic impairment.
Adverse Reactions
 Superinfection; nausea, vomiting, abdominal pain, anorexia, diarrhoea; rash, leukopenia, thrombocytopaenia, haemorrhage, elevated transaminases.
Potentially Fatal: Anaphylactic reaction; pseudomembranous colitis.
Drug Interactions
 Probenecid reduces tubular secretion of cefazolin thereby prolonging its half-life. Disulfiram-like reaction with alcohol.
Potentially Fatal: Concurrent use with furosemide and aminoglycosides increase risk of nephrotoxicity.
See Below for More cefazolin Drug Interactions
Lab Interactions
 False-positive results for direct Coombs' test and urine sugar (Benedict's, Fehling's or other reagents but not with enzyme-based methods). Interferes with Jaffe method of measuring creatinine.
Mechanism of Actions
 Cefazolin binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption: Poorly absorbed from the GI tract (oral).
Distribution: Bile (high concentrations); bone; ascitic, pleural and synovial fluids; CSF (small amounts). Crosses the placenta into the foetal circulation; enters the breast milk (low concentrations). Protein-binding: 85%
Excretion: Via the urine by glomerular filtration, with some renal tubular secretion (as unchanged); 80% of a dose within 24 hr (IM). Removed to some extent by haemodialysis.
Storage Conditions
 Parenteral: Store at 25°C.
ATC Classification
 J01DB04 - cefazolin ; Belongs to the class of first-generation cephalosporins. Used in the systemic treatment of infections.
Storage
 Parenteral: Store at 25°C.
Available As
  • Cefazolin 1 gm
  • Cefazolin 1000 mg
  • Cefazolin 125 mg
  • Cefazolin 250 mg
  • Cefazolin 500 mg

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