Cefazolin

What is Cefazolin?

• Cefazolin (Ancef; Kefzol) is a cephalosporin antibacterial is used to treat certain infections caused by bacteria including skin, bone, joint, genital, blood, heart valve, respiratory tract (including pneumonia), biliary tract, and urinary tract infections.
• It is also may be used before, during, and sometimes for a brief period after surgery in order to prevent the patient from getting an infection.

Cefazolin

What are the uses of this medicine?

Cefazolin (Ancef; Kefzol) is used for: Treatment of the following infections caused by susceptible isolates of the designated microorganisms in adult and pediatric patients:

• Respiratory tract infections
• Urinary tract infections
• Skin and skin structure infections
• Biliary tract infections
• Bone and joint infections
• Genital infections
• Septicemia
• Endocarditis
• Perioperative prophylaxis in adults for whom appropriate dosing with this formulation can be achieved

How does this medicine work?

• Cefazolin is an antibacterial drug.
• Cefazolin is a bactericidal agent that acts by inhibition of bacterial cell wall synthesis.

Cefazolin has been shown to be active against most isolates of the following microorganisms: Gram-Positive Bacteria:

• Staphylococcus aureus
• Staphylococcus epidermidis
• Streptococcus agalactiae
• Streptococcus pneumoniae
• Streptococcus pyogenes
• Methicillin-resistant staphylococci are uniformly resistant to cefazolin.

Gram-Negative Bacteria:

• Escherichia coli
• Proteus mirabilis

Who Should Not Use this medicine ?

This medicine cannot be used in patients who:

• have a history of immediate hypersensitivity reactions (e.g., anaphylaxis, serious skin reactions) to cefazolin or the cephalosporin class of antibacterial drugs, penicillins, or other beta-lactams.

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention any of the following:

• probenecid (Probalan)

Is this medicine FDA approved?

• Cefazolin was patented in 1967 and came into commercial use in 1971.

How should this medicine be used?

Recommended dosage:

Recommended Dosing Schedule in Adult Patients:

Recommended Dosing Schedule in Adult Patients with CLcr Greater Than or Equal To 55 mL/min*.

Site and Type of Infection	Dose	Frequency
Moderate to severe infections	500 mg to 1 gram	every 6 to 8 hours
Mild infections caused by susceptible gram-positive cocci	250 mg to 500 mg	every 8 hours
Acute, uncomplicated urinary tract infections	1 gram	every 12 hours
Pneumococcal pneumonia	500 mg	every 12 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia)	1 gram to 1.5 grams	every 6 hours

Recommended Dosage in Pediatric Patients:

Recommended Dosage in Pediatric Patients with CLcr 70 mL/min or greater for Treatment of Infections

Type of Severity	Recommended Total Daily Dosage
Mild to moderate infections	25 mg/kg to 50 mg/kg, divided into 3 or 4 equal doses
Severe infections	May increase to 100 mg/kg, divided into 3 or 4 equal doses

Recommended Dosage for Perioperative Prophylaxis in Adults:

• 500 mg to 1 g every 6 hours to 8 hours.

Dose administered ½ hour to 1 hour prior to the start of surgery:

• 1 g to 2 g

Administration:

• Cefazolin injection comes as a powder to be mixed with liquid, or as a premixed product, to be injected intravenously over a period of 30 minutes.
• Cefazolin injection can also be given intramuscularly.
• It is usually given every 6, 8, or 12 hours.
• The length of your treatment depends on the type of infection you have and how your body responds to the medication.
• You may receive cefazolin injection in a hospital or you may administer the medication at home.
• If you will be receiving cefazolin injection at home, your healthcare provider will show you how to use the medication.
• Use cefazolin injection until you finish the prescription, even if you feel better.
• If you stop using cefazolin injection too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Injection: 1 gram cefazolin per 50 mL or 2 gram cefazolin per 100 mL

This medicine is available in fallowing brand namesː

• Ancef; Kefzol

What side effects can this medication cause?

The most common side effects of this medicine include:

• Gastrointestinal: Diarrhea, oral candidiasis (oral thrush), mouth ulcers, vomiting, nausea, stomach cramps, epigastric pain, heartburn, flatus, anorexia and pseudomembranous colitis.
• Allergic: Anaphylaxis, eosinophilia, urticaria, itching, drug fever, skin rash, Stevens-Johnson syndrome.
• Hematologic: Neutropenia, leukopenia, thrombocytopenia, thrombocythemia.
• Hepatic: Transient rise in SGOT, SGPT, and alkaline phosphatase levels has been observed. Reports of hepatitis have been received.
• Renal: Reports of increased BUN and creatinine levels, as well as renal failure, have been received.
• Local Reactions: Instances of phlebitis have been reported at site of injection. Some induration has occurred.
• Other Reactions: Pruritus (including genital, vulvar and anal pruritus, genital moniliasis, and vaginitis). Dizziness, fainting, lightheadedness, confusion, weakness, tiredness, hypotension, somnolence and headache.

Less common but serious side effects, may include:

• Hypersensitivity reactions
• Seizures in Patients with Renal Impairment
• Clostridioides difficile-associated diarrhea

What special precautions should I follow?

• Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. If an allergic reaction to cefazolin injection occurs, discontinue the drug.
• Seizures may occur with the administration of cefazolin injection, particularly in patients with renal impairment when the dosage is not reduced appropriately. Discontinue cefazolin injection if seizures occur or make appropriate dosage adjustments in patients with renal impairment.
• Clostridioides difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including cefazolin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
• If CDAD is suspected or confirmed, ongoing antibacterial drug use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibacterial drug treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
• Hypersensitivity reactions, including anaphylaxis, have been reported with administration of dextrose- containing products.
• Prescribing cefazolin injection in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
• The administration of cefazolin may result in a false-positive reaction with glucose in the urine when using glucose tests based on Benedict’s copper reduction reaction that determine the amount of reducing substances like glucose in the urine.
• Positive direct Coombs' tests have been reported during treatment with cefazolin.
• As with other dextrose-containing solutions, cefazolin injection should be prescribed with caution in patients with overt or known subclinical diabetes mellitus or carbohydrate intolerance for any reason.
• Patients should be counseled that antibacterial drugs, including cefazolin injection should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold).
• There are no data on the effects of cefazolin on the breastfed child or on milk production.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• seizures may occur in patients with renal impairment

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• If seizures associated with accidental overdosage occur, discontinue cefazolin injection and give supportive treatment.

Can this medicine be used in pregnancy?

• Cephalosporin use, including cefazolin, in pregnant women have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.
• Cefazolin crosses the placenta.

Can this medicine be used in children?

• Cefazolin injection is indicated for the treatment of respiratory tract infections, urinary tract infections, skin and skin structure infections, biliary tract infections, bone and joint infections, genital infections, septicemia, and endocarditis in pediatric patients.
• Safety and effectiveness of cefazolin injection in premature infants and neonates have not been established and is not recommended for use in this age group of pediatric patients.

What are the active and inactive ingredients in this medicine?

Active ingredients:

• cefazolin sodium

Inactive ingredients:

• anhydrous dextrose
• sodium bicarbonate
• water
• hydrochloric acid
• sodium hydroxide

Who manufactures and distributes this medicine?

Manufactured by:

• Baxter Healthcare Corporation,
• Deerfield, IL USA
• Made in USA

What should I know about storage and disposal of this medication?

• Store at or below -20°C (-4°F). Thaw at room temperature 20-25°C (68 - 77°F)
• or under refrigeration 2-8°C (36 - 46°F).
• Product should not be thawed by immersion in water baths or by microwave irradiation.
• Do not force thaw.
• Thawed solution is stable for 30 days under refrigeration or 48 hours at room temperature.
• Do not force thaw by immersion in water baths or by microwave irradiation.
• Do not refreeze.

• Dailymed label info on Cefazolin
• FDA Cefazolin