Class: Antibiotic, Cephalosporin
- Powder for injection 500 mg
- Powder for injection 1 g
- Powder for injection 10 g
- Powder for injection 20 g
Inhibition of bacterial cell wall synthesis.
Following a 500 mg dose, mean serum concentrations are 37 and 3 mcg/mL at 1 and 8 h, respectively. After a 1 g dose, mean serum levels are 64 and 7 mcg/mL at 1 and 8 h, respectively.
Bile concentrations can exceed serum levels by up to 5 times. Promptly crosses the placenta.
IM t ½ approximately 2 h and IV t ½ approximately 1.8 h. Excreted unchanged in urine. Approximately 60% excreted in urine in 6 h and 70% to 80% within 24 h. Peak urine concentrations after IM doses of 500 mg and 1 g are approximately 2,400 and 4,000 mcg/mL, respectively.
Indications and Usage
Treatment of infections of respiratory tract, urinary tract, skin and skin structures, biliary tract, and bone and joint; treatment of genital infections; treatment of septicemia; treatment of endocarditis caused by susceptible strains of specific microorganisms; perioperative prophylaxis.
Hypersensitivity to cephalosporins.
Dosage and AdministrationInfection
IM/IV Moderate to severe infections: 500 mg to 1 g every 6 to 8 h. Mild infections: 250 to 500 mg every 8 h. Severe, life-threatening infections: 1 to 1.5 g every 6 h.Children older than 1 month of age
IM/IV Mild to moderate infections: 25 to 50 mg/kg (10 to 20 mg/lb) daily divided into 3 or 4 equal doses. Severe infections: 100 mg/kg (45 mg/lb).Acute Uncomplicated UTIs
IM/IV 1 g every 12 h.Pneumococcal Pneumonia
IM/IV 500 mg every 12 h.Perioperative Prophylaxis
IM/IV 1 g administered ½ to 1 h prior to start of surgery. Operative procedures of 2 h or more: 500 mg to 1 g during surgery. Postoperatively: 500 mg to 1 g every 6 to 8 h for 24 h.Renal Function Impairment
IM/IV Ccr 55 mL/min or greater: Administer full dose. Ccr 35 to 54 mL/min: Administer full dose restricted to at least 8 h intervals. Ccr 11 to 34 mL/min: Administer 50% of usual dose every 12 h. Ccr 10 mL/min or less: Administer 50% of usual dose every 18 to 24 h.Children older than 1 month of age
IM/IV Dosage recommendations apply after an initial loading dose. Ccr 70 to 40 mL/min: Administer 60% of normal daily dose in equally divided doses every 12 h. Ccr 40 to 20 mL/min: Administer 25% of normal daily dose in equally divided doses every 12 h. Ccr 20 to 5 mL/min: Administer 10% of normal daily dose every 24 h.
- Shake well when reconstituted.
- Inspect visually for particulate matter prior to administration; discard if particulate matter is evident.
- Reconstituted solution may be pale yellow to yellow without a change in potency.
Before reconstitution, store at 68° to 77°F. Protect from light. When reconstituted or diluted, stable for 24 h at room temperature or 10 days under refrigeration at 41°F.
Drug InteractionsAminoglycosides (eg, gentamicin)
Increased risk of nephrotoxicity.Probenecid
Cefazolin renal tubular secretion may be decreased, increasing and prolonging blood levels.Warfarin
Anticoagulant effect may be increased.
Laboratory Test Interactions
False-positive direct Coombs test results may occur; false-positive reaction to glucose in the urine may occur with Benedict solution, Fehling solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix ).
Abdominal pain; anal pruritus; anorexia; colitis; diarrhea; nausea; oral candidiasis; pseudomembranous colitis; stomach cramps; vomiting.
Genital pruritus (including genital moniliasis, vaginitis, vulvar pruritus).
Agranulocytosis; aplastic anemia; hemolytic anemia; hemorrhage; leukopenia; neutropenia; pancytopenia; thrombocythemia; thrombocytopenia.
Increased alkaline phosphatase, AST, or ALT; elevated bilirubin; elevated LDH; increased creatine; prolonged prothrombin time.
Increased BUN and creatinine; renal function impairment; toxic nephropathy.
Allergy (including anaphylaxis, drug fever, eosinophilia, erythema multiforme, itching, skin rash, serum sickness–like reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria); superinfection.
Category B .
Excreted in breast milk.
Safety and efficacy not established in children 1 month of age or younger.
Dosage adjustment may be needed.
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Use with caution, especially in patients with history of colitis.
May be decreased.
Consider in patients who develop diarrhea.
- Advise patient to report nausea, vomiting, diarrhea, skin rash, hives, and muscle or joint pain to health care provider.
- Advise patient to maintain normal fluid intake while receiving this medication.
- Instruct patient to report signs of superinfection: black, furry tongue; white patches in mouth; foul-smelling stools; vaginal itching or discharge.
- Instruct patient to immediately seek emergency care if wheezing or difficulty breathing occurs.
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