Cefazolin parenteral
- Drugs List
- Therapeutic Indications
- Dosage
- Administration
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Parenteral formulations of cefazolin (as cefazolin sodium).
Drugs List
Therapeutic Indications
Uses
Bone and joint infection
Prophylaxis against infection during surgical procedures
Skin and soft tissue infections
Skin and soft tissue infections caused by cefazolin-susceptible micro-organisms.
Bone and joint infections caused by cefazolin-susceptible micro-organisms.
Perioperative prophylaxis. For surgical operations with increased risk of infections with anaerobic pathogens. Combination with an appropriate drug with activity against anaerobes is recommended.
Dosage
The dosage as well as the method of administration are dependent on the location and severity of the infection and on the clinical and bacteriological progress.
Adults
Infections caused by sensitive micro-organisms
1g to 2g cefazolin per day, given in two or three equal doses.
Infections caused by moderately sensitive micro-organisms
3g to 4g cefazolin per day, given in three or four equal doses.
Severe infections
Up to 6g cefazolin per day, given in three or four equal doses (or every 6 to 8 hours).
Peri-operative prophylaxis
1g cefazolin given 30 to 60 minutes before surgery. An additional 500mg to 1g can be given if required during surgery in long surgical interventions (2 hours or more).
Children
Children over 12 years and weighing 40kg or more
Infections caused by sensitive micro-organisms
1g to 2g cefazolin per day, given in two or three equal doses.
Infections caused by moderately sensitive micro-organisms
3g to 4g cefazolin per day, given in three or four equal doses.
Severe infections
Up to 6g cefazolin per day, given in three or four equal doses (or every 6 to 8 hours).
Peri-operative prophylaxis
1g cefazolin given 30 to 60 minutes before surgery. An additional 500mg to 1g can be given if required during surgery in long surgical interventions (2 hours or more).
Children under 12, or over 12 weighing below 40kg
Infections caused by sensitive micro-organisms
25mg to 50mg cefazolin per kg of bodyweight per day, given in two to four equal doses (one dose every 6, 8 or 12 hours).
Infections caused by moderately sensitive micro-organisms
Up to 100mg cefazolin per kg of bodyweight per day, given in three or four equal doses( one dose every 6 or 8 hours).
Patients with Renal Impairment
Adults and children aged 12 years or older and weighing 40kg or more
55ml/min creatinine clearance or more (1.5mg/dl serum creatinine or less)
Normal dose, and normal dosage interval.
35-54ml/min creatinine clearance (1.6-3.0mg/dl serum creatinine)
Normal dose, every 8 hours.
11-34ml/min creatinine clearance (3.1-4.5mg/dl serum creatinine)
Half of normal dose, every 12 hours.
10ml/min creatinine clearance or less (4.6mg/dl serum creatinine or more)
Half of normal dose, every 18-24 hours.
Children under 12, or over 12 weighing below 40kg
20-40ml/min creatinine clearance
25% of the normal daily dose, given every 12 hours.
5-20ml/min creatinine clearance
10% of the normal daily dose, given every 24 hours.
Administration
Cefazolin 1g powder for solution for injection
For slow intravenous injection, intravenous infusion or intramuscular injection after appropriate dilution.
Cefazolin 2g powder for solution for injection
For slow intravenous injection or intravenous infusion after appropriate dilution.
Contraindications
Neonates
Precautions and Warnings
Allergic disposition
Restricted sodium intake
Allergic rhinitis
Asthma
Breastfeeding
Pregnancy
Renal impairment
Contains more than 1 mmol (23 mg) sodium per dose
Reduce dose in patients with glomerular filtration rate below 55ml/min
Consult national/regional policy on the use of anti-infectives
Monitor INR in patients with coagulation defects or at risk of haemorrhages
Perform blood counts on prolonged use of this treatment
Consider pseudomembranous colitis if patient presents with diarrhoea
Prolonged use may result in superinfection with non-susceptible organisms
May cause false positive Coomb's test and glycosuria test
Discontinue at once if pseudomembranous colitis occurs
Discontinue if severe hypersensitivity reactions occur
Discontinue if signs of eosinophilia myalgia syndrome (EMS) occur
Pregnancy and Lactation
Pregnancy
Use cefazolin with caution during pregnancy.
The manufacturer warns that as a precautionary measure cefazolin should only be used in pregnant woman after careful consideration of the risks and benefits. Cefazolin is known to pass the placenta and reach the embryo/foetus, but it's effect is unknown.
Lactation
Use cefazolin with caution during breastfeeding.
The manufacturer warns that as a precautionary measure cefazolin should only be used while breastfeeding after careful consideration of the risks and benefits. Cefazolin is known to be excreted into breast milk at low concentrations. Diarrhoea and fungal infections have been observed in the breast fed infant, consider stopping breastfeeding or withdrawing cefazolin.
Lactmed (2018) states that cefazolin use is not expected to cause any serious adverse effects in breast fed infants, and it's use is acceptable in nursing mothers.
Side Effects
Agranulocytosis
Anaemia
Anal pruritus
Anaphylactic shock
Angioedema
Anxiety
Aplastic anaemia
Basophilia
Candidiasis (mouth or throat)
Chest pain
Cholestatic jaundice
Coagulation disorders
Colour vision deficiencies
Confusion
Cough
Decrease in blood pressure
Decrease in haemoglobin and haematocrit
Decreased appetite
Diarrhoea
Dizziness
Drowsiness
Drug fever
Dyspnoea
Eosinophilia
Epileptogenic activity
Erythema
Erythema multiforme
Exanthema
Facial oedema
Fatigue
Gamma glutamyl transferase (GGT) increased
Genital candidiasis
Genital pruritus
Granulocytopenia
Granulocytosis
Haemolytic anaemia
Hepatitis (transient)
Hot flushes
Hyperactivity
Hyperglycaemia
Hypoglycaemia
Increase in alkaline phosphatase
Increase in blood urea nitrogen
Increase in lactate dehydrogenase
Increase in serum ALT/AST
Increased heart rate
Insomnia
Interstitial nephritis
Interstitial pneumonia
Laryngitis
Leukocytosis
Leukopenia
Lymphocytopenia
Malaise
Monocytosis
Nausea
Nephropathy
Nephrotoxicity
Nervousness
Neutropenia
Nightmares
Pain on intramuscular injection
Pancytopenia
Pleural effusion
Pneumonitis
Proteinuria
Pseudomembranous colitis
Respiratory distress
Rhinitis
Seizures
Serum bilirubin increased
Shortness of breath
Stevens-Johnson syndrome
Thrombocytopenia
Thrombophlebitis
Tongue swelling
Toxic epidermal necrolysis
Urticaria
Vaginitis
Vertigo
Vomiting
Weakness
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: March 2019
Reference Sources
Summary of Product Characteristics: Cefazolin 1g powder for solution for injection/infusion. Kent Pharma (UK) Ltd. Revised December 2018.
Summary of Product Characteristics: Cefazolin 2g powder for solution for injection/infusion. MIP Pharma GmbH. Revised February 2015.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 18 May 2022
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Cefazolin. Last revised: 31 October 2018
Last accessed: 18 May 2022.
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.