Cefazolin

General

• Type: 1st gen Cephalosporin
• Dosage Forms: IV, IM
• Common Trade Names: Ancef

Adult Dosing

General

• Mild: 250-500 mg IM/IV 8h
• Mod-Severe: 500-1000 mg IM/IV q6-8h
• Life Threatening: 1-1.5g IM/IV q6h
• Max: 12g/day

UTI, Uncomplicated

• 1g IM/IV q12

Pneumococcal Pneumonia

• 500mg IM/IV q12

Endocarditis Prophylaxis, Dental

• 1g IM/IV x1 (30-60 min before procedure)

Pediatric Dosing

General (<7 Days)

• 40 mg/kg/day IM/IV divided q12h
• First Dose: 20mg/kg IM/IV x 1
• Max 6g/day

General (>7 Days - 1 Month)

• <2000g
  • 40 mg/kg/day IM/IV divided q12h
  • First Dose: 20mg/kg IM/IV x 1
  • Max 6g/day
• >2000g
  • 60 mg/kg/day IM/IV divided q8h
  • First Dose: 20mg/kg IM/IV x 1
  • Max 6g/day

General (>1 Month)

• 25-100 mg/kg/day IM/IV divided q6-8h
• First Dose: 20-33mg/kg IM/IV x 1
• Max 6g/day

Community Acquired Pneumonia (>3 Months)

• 150 mg/kg/day IM/IV divided q8h x 10 days
• First Dose: 50 mg/kg IM/IV x 1
• May switch to PO regimen when able

Special Populations

• Pregnancy: B
• Lactation: Safe
• Renal
  • Adult
    • CrCl 35-54: give q8
    • CrCl 11-34: give usual dose x1, then decrease dose 50% and give q12h
    • CrCl <10: give usual dose x1, then decrease dose 50% and give q18-24h
    • Hemodialysis: give 0.5-1g supplement
    • Peritoneal dialysis: 500 mg q12h
  • Pediatric
    • CrCl 40-70: give usual dose x 1, then decrease daily dose 40% and give q12h
    • CrCl 20-39: give usual dose x 1, then decrease daily dose 75% and give q12h
    • CrCl 5-19: give usual dose x 1, the decerase daily dose 90% and give q24h
    • CrCl <5: not defined
    • Hemodialysis: give supplement
    • Peritoneal dialysis: no supplement
• Hepatic (Adult & Pediatric)
  • Not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Neutropenia
• Thrombocytopenia
• Anaphylaxis
• Steven-Johnson Syndrome
• Nephrotoxicity
• Seizures
• Clostridium difficile

Common

• Diarrhea
• Rash
• Nausea and Vomiting
• Abdominal Pain
• Anorexia
• Transaminitis
• Urticaria
• Thrombophlebitis

Pharmacology

• Half-life: 1.8h (3.7 ESRD)
• Metabolism: other; CYP450
• Excretion: Urine
• Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

See Also

• Antibiotics (Main)

Source

• Epocrates