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cefazolin (injection)

Pronunciation

Generic Name: cefazolin (injection) (sef A zoe lin)
Brand Name: Ancef, Kefzol

What is cefazolin?

Cefazolin is a cephalosporin (SEF a low spor in) antibiotic. It works by fighting bacteria in your body.

Cefazolin is used to treat many kinds of bacterial infections, including severe or life-threatening forms.

Cefazolin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about cefazolin?

You should not use cefazolin if you have ever had a severe allergic reaction to any type of cephalosporin antibiotic (Omnicef, Cefzil, Ceftin, Keflex, and others).

What should I discuss with my health care provider before using cefazolin?

You should not use this medicine if you have ever had a severe allergic reaction to cefazolin or any other cephalosporin antibiotic, such as:

  • cefaclor (Raniclor);

  • cefadroxil (Duricef);

  • cefdinir (Omnicef);

  • cefazolin (Ancef);

  • cefditoren (Spectracef);

  • cefpodoxime (Vantin);

  • cefprozil (Cefzil);

  • ceftibuten (Cedax);

  • cefuroxime (Ceftin);

  • cephalexin (Keflex); or

  • cephradine (Velosef).

To make sure cefazolin is safe for you, tell your doctor if you have:

  • kidney disease;

  • liver disease;

  • a stomach or intestinal disorder such as colitis;

  • if you are malnourished; or

  • if you are allergic to any type of penicillin.

Cefazolin is not expected to harm an unborn baby. Tell your doctor if you are pregnant.

Cefazolin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use cefazolin?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Cefazolin is injected into a muscle or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, syringes, IV tubing, and other items used to inject the medicine.

Cefazolin must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medicine.

Shake the mixture well just before you measure a dose. Do not use the medicine if it has changed colors or has particles in it. Call your doctor for a new prescription.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Cefazolin will not treat a viral infection such as the flu or a common cold.

Cefazolin can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using cefazolin.

Store unmixed cefazolin dry powder at room temperature, away from moisture, heat, and light.

After mixing cefazolin with a diluent, you may store the mixture in the refrigerator and use it within 10 days. Do not freeze. Follow the storage directions on your medicine label.

You may store the mixture for up to 24 hours at room temperature.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of cefazolin.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using cefazolin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop using cefazolin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Cefazolin side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea that is watery or bloody;

  • white patches or sores inside your mouth or on your lips;

  • fever, swollen glands, rash or itching, joint pain, or general ill feeling;

  • seizure (convulsions);

  • liver problems--upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • stomach pain, loss of appetite;

  • rectal itching; or

  • vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Cefazolin dosing information

Usual Adult Dose for Cholecystitis:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Epididymitis -- Non-Specific:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Joint Infection:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Osteomyelitis:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Prostatitis:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Skin or Soft Tissue Infection:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Bacterial Infection:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Skin and Structure Infection:

Mild infections due to susceptible gram-positive cocci: 250 to 500 mg IV or IM every 8 hours
Moderate to severe infections: 500 mg to 1 g IV or IM every 6 to 8 hours
Severe, life-threatening infections (e.g., endocarditis, septicemia): 1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used for severe, life-threatening infections.

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to Escherichia coli, various strains of streptococci, Proteus mirabilis, Klebsiella species, and Staphylococcus aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to Streptococcus pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and Haemophilus influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci

Usual Adult Dose for Septicemia:

1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used.

Use: For the treatment of septicemia due to S pneumoniae, S aureus, P mirabilis, E coli, and Klebsiella species

Usual Adult Dose for Endocarditis:

1 to 1.5 g IV every 6 hours

Comments:
-In rare cases, doses up to 12 g/day have been used.

Use: For the treatment of endocarditis due to S aureus and S pyogenes/group A beta-hemolytic streptococci

American Heart Association (AHA) and Infectious Diseases Society of America (IDSA) Recommendations: 2 g IV every 8 hours

Duration of Therapy:
-Native valve infective endocarditis: 6 weeks
-Endocarditis involving a prosthetic valve or other prosthetic material: At least 6 weeks

Comments:
-Recommended for infections due to oxacillin-susceptible strains of staphylococci in penicillin-allergic (nonanaphylactoid type) patients
-For infection involving a prosthetic valve or other prosthetic material: This drug should be used with gentamicin for the first 2 weeks and rifampin for at least 6 weeks.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Pneumonia:

500 mg IV or IM every 12 hours

Use: For the treatment of pneumococcal pneumonia

Usual Adult Dose for Urinary Tract Infection:

1 g IV or IM every 12 hours

Use: For the treatment of acute, uncomplicated urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

Usual Adult Dose for Surgical Prophylaxis:

Preoperative: 1 to 2 g IV or 1 g IM 30 to 60 minutes before the start of surgery
Intraoperative (for procedures lasting 2 hours or more): 500 mg to 1 g IV or IM during surgery
Postoperative: 500 mg to 1 g IV or IM every 6 to 8 hours for 24 hours

Comments:
-Preoperative, intraoperative, and postoperative use of this drug may reduce the incidence of certain postoperative infections in patients undergoing surgical procedures classified as contaminated or potentially contaminated (e.g., vaginal hysterectomy, cholecystectomy in high-risk patients [e.g., older than 70 years, acute cholecystitis, obstructive jaundice, common duct bile stones]).
-The preoperative dose should be administered just prior (30 to 60 minutes) to the start of surgery so that there are adequate antibiotic levels in the serum and tissues when the first incision is made.
-This drug should be administered (if necessary) at appropriate intervals during surgery to provide adequate antibiotic levels at expected moments of highest exposure to infective organisms; for lengthy surgical procedures (e.g., 2 hours or more), drug administration should be adjusted based on the duration of the procedure.
-Perioperative use may also be effective in surgical patients for whom infection at the operative site would present serious risk (e.g., during open-heart surgery and prosthetic arthroplasty); prophylactic administration may be continued for 3 to 5 days after surgery completed.
-If signs of infection observed, specimens for culture and susceptibility testing should be obtained to isolate and identify infecting organisms in order to start appropriate therapy.

Use: As perioperative prophylaxis to prevent postoperative infection in contaminated or potentially contaminated surgery

American Society of Health-System Pharmacists (ASHP), IDSA, Surgical Infection Society (SIS), and Society for Healthcare Epidemiology of America (SHEA) Recommendations:
Preoperative dose:
-Less than 120 kg: 2 g IV as a single dose
-At least 120 kg: 3 g IV as a single dose

Redosing interval (from start of preoperative dose): 4 hours

Comments:
-This drug should be started within 60 minutes before surgical incision.
-A single prophylactic dose is usually sufficient; if prophylaxis is continued postoperatively, duration should be less than 24 hours.
-To ensure adequate serum and tissue drug levels, readministration may be needed if the procedure duration exceeds the recommended redosing interval.
-Redosing may be needed if drug half-life is shortened (e.g., extensive burns) or if prolonged/excessive bleeding during surgery; redosing may not be needed if drug half-life is prolonged (e.g., renal dysfunction).
-Coadministration with other agents may be recommended, depending on type of procedure.
-Current guidelines should be consulted for additional information.

Uses: Recommended for surgical prophylaxis for the following procedures:
-Appendectomy for uncomplicated appendicitis
-Biliary tract: Open procedure; elective, high-risk laparoscopic procedure
-Cardiac: Coronary artery bypass; cardiac device insertion procedures (e.g., pacemaker implantation); ventricular assist devices
-Cesarean delivery
-Colorectal
-Gastroduodenal: Procedures involving entry into lumen of gastrointestinal (GI) tract (bariatric, pancreaticoduodenectomy); procedures without entry into GI tract (antireflux, highly selective vagotomy) for high-risk patients
-Head and neck: Clean with placement of prosthesis (excludes tympanostomy tubes); clean-contaminated cancer surgery; other clean-contaminated procedures (excluding tonsillectomy, functional endoscopic sinus procedures)
-Heart, lung, heart-lung transplantation
-Hernia repair (hernioplasty and herniorrhaphy)
-Hysterectomy: Vaginal or abdominal
-Neurosurgery: Elective craniotomy and CSF-shunting procedures; implantation of intrathecal pumps
-Orthopedic: Spinal procedures with and without instrumentation; hip fracture repair, implantation of internal fixation devices (e.g., nails, screws, plates, wires); total joint replacement
-Pancreas, pancreas-kidney transplantation
-Plastic surgery: Clean with risk factors or clean-contaminated
-Small intestine: Nonobstructed; obstructed
-Thoracic: Noncardiac procedures (including lobectomy, pneumonectomy, lung resection, thoracotomy); video-assisted thoracoscopic surgery
-Urologic: Lower tract instrumentation with risk factors for infection (includes transrectal prostate biopsy); clean without entry into urinary tract and involving implanted prosthesis; clean with entry into urinary tract; clean-contaminated
-Vascular

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

AHA Recommendations: 1 g IV or IM as a single dose 30 to 60 minutes before procedure

Comments:
-Recommended as an alternative in patients, with or without penicillin/ampicillin allergy, unable to take oral medication (unless history of anaphylaxis, angioedema, or urticaria with penicillins or ampicillin)
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Prevention of Perinatal Group B Streptococcal Disease:

US CDC Recommendations: 2 g IV initially followed by 1 g IV every 8 hours until delivery

Comments:
-Recommended as the preferred agent for penicillin-allergic (nonanaphylactoid type) patients
-Use of this drug for at least 4 hours before delivery is considered adequate intrapartum antibiotic prophylaxis.
-Current guidelines should be consulted for additional information.

Use: As intrapartum antibiotic prophylaxis for prevention of early-onset group B streptococcal disease

Usual Adult Dose for Peritonitis:

International Society for Peritoneal Dialysis (ISPD) Recommendations:
Continuous (all exchanges):
-Loading dose: 500 mg/L intraperitoneally
-Maintenance dose: 125 mg/L intraperitoneally

Intermittent (1 exchange daily): 15 to 20 mg/kg intraperitoneally once a day

Duration of Therapy: 14 to 21 days

Comments:
-Intraperitoneal antibiotics can be administered continuously (i.e., in each exchange) or intermittently (i.e., once a day).
-In intermittent dosing, the antibiotic-containing dialysis solution should dwell for at least 6 hours to allow adequate absorption.
-Current guidelines should be consulted for additional information.

Use: For the treatment of peritoneal dialysis (PD)-related peritonitis

Usual Pediatric Dose for Cholecystitis:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Epididymitis -- Non-Specific:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Joint Infection:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Osteomyelitis:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Pneumonia:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Prostatitis:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Skin or Soft Tissue Infection:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Bacterial Infection:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Urinary Tract Infection:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Skin and Structure Infection:

1 month or older:
-Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 or 4 equally divided doses
-Severe infections: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Uses: For the treatment of the following infections due to susceptible bacteria:
-Biliary tract infections due to E coli, various strains of streptococci, P mirabilis, Klebsiella species, and S aureus
-Bone and joint infections due to S aureus
-Genital infections (i.e., prostatitis, epididymitis) due to E coli, P mirabilis, Klebsiella species, and some strains of enterococci
-Respiratory tract infections due to S pneumoniae, S aureus, S pyogenes/group A beta-hemolytic streptococci, Klebsiella species, and H influenzae
-Skin and skin structure infections due to S aureus, S pyogenes/group A beta-hemolytic streptococci, S agalactiae, and other strains of streptococci
-Urinary tract infections due to E coli, P mirabilis, Klebsiella species, and some strains of Enterobacter and enterococci

American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25 mg/kg IV or IM every 12 hours

8 to 28 days:
Up to 2 kg: 25 mg/kg IV or IM every 12 hours
Greater than 2 kg: 25 mg/kg IV or IM every 8 hours

1 month or older:
Mild to moderate infections: 25 to 50 mg/kg/day IV or IM in 3 divided doses
Maximum dose: 3 g/day

Severe infections: 100 to 150 mg/kg IV or IM in 3 divided doses
Maximum dose: 6 g/day

Usual Pediatric Dose for Septicemia:

1 month or older: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Use: For the treatment of septicemia due to S pneumoniae, S aureus, P mirabilis, E coli, and Klebsiella species

Usual Pediatric Dose for Endocarditis:

1 month or older: 100 mg/kg/day IV or IM in 3 or 4 equally divided doses

Use: For the treatment of endocarditis due to S aureus and S pyogenes/group A beta-hemolytic streptococci

AHA Recommendations:
1 year or older: 100 mg/kg/day IV in divided doses every 8 hours
Maximum dose: 12 g/day
Duration of Therapy: At least 4 to 6 weeks

Comments:
-Alternative regimen for highly penicillin G-susceptible streptococci (minimum bactericidal concentration [MBC] up to 0.1 mcg/mL), staphylococci (S aureus or coagulase-negative staphylococci) susceptible to up to 1 mcg/mL penicillin G (rare), and staphylococci resistant to 0.1 mcg/mL penicillin G
-Streptococci highly susceptible to penicillin G include most viridans streptococci, groups A, B, C, G, nonenterococcal group D streptococci (S bovis, S equinus).
-For staphylococci resistant to 0.1 mcg/mL penicillin G, this drug may be used with or without gentamicin for the first 3 to 5 days.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

AHA Recommendations:
Children: 50 mg/kg IV or IM as a single dose 30 to 60 minutes before procedure
Maximum dose: 1 g/dose

Comments:
-Recommended as an alternative in patients, with or without penicillin/ampicillin allergy, unable to take oral medication (unless history of anaphylaxis, angioedema, or urticaria with penicillins or ampicillin)
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Surgical Prophylaxis:

ASHP, IDSA, SIS, and SHEA Recommendations:
Preoperative dose: 30 mg/kg IV as a single dose
Maximum dose:
-Less than 120 kg: 2 g/dose
-At least 120 kg: 3 g/dose

Redosing interval (from start of preoperative dose): 4 hours

Comments:
-This drug should be started within 60 minutes before surgical incision.
-A single prophylactic dose is usually sufficient; if prophylaxis is continued postoperatively, duration should be less than 24 hours.
-To ensure adequate serum and tissue drug levels, readministration may be needed if the procedure duration exceeds the recommended redosing interval.
-Redosing may be needed if drug half-life is shortened (e.g., extensive burns) or if prolonged/excessive bleeding during surgery; redosing may not be needed if drug half-life is prolonged (e.g., renal dysfunction).
-Coadministration with other agents may be recommended, depending on type of procedure.
-Current guidelines should be consulted for additional information.

Uses: Recommended for surgical prophylaxis for the following procedures:
-Appendectomy for uncomplicated appendicitis
-Biliary tract: Open procedure; elective, high-risk laparoscopic procedure
-Cardiac: Coronary artery bypass; cardiac device insertion procedures (e.g., pacemaker implantation); ventricular assist devices
-Cesarean delivery
-Colorectal
-Gastroduodenal: Procedures involving entry into lumen of GI tract (bariatric, pancreaticoduodenectomy); procedures without entry into GI tract (antireflux, highly selective vagotomy) for high-risk patients
-Head and neck: Clean with placement of prosthesis (excludes tympanostomy tubes); clean-contaminated cancer surgery; other clean-contaminated procedures (excluding tonsillectomy, functional endoscopic sinus procedures)
-Heart, lung, heart-lung transplantation
-Hernia repair (hernioplasty and herniorrhaphy)
-Hysterectomy: Vaginal or abdominal
-Neurosurgery: Elective craniotomy and CSF-shunting procedures; implantation of intrathecal pumps
-Orthopedic: Spinal procedures with and without instrumentation; hip fracture repair, implantation of internal fixation devices (e.g., nails, screws, plates, wires); total joint replacement
-Pancreas, pancreas-kidney transplantation
-Plastic surgery: Clean with risk factors or clean-contaminated
-Small intestine: Nonobstructed; obstructed
-Thoracic: Noncardiac procedures (including lobectomy, pneumonectomy, lung resection, thoracotomy); video-assisted thoracoscopic surgery
-Urologic: Lower tract instrumentation with risk factors for infection (includes transrectal prostate biopsy); clean without entry into urinary tract and involving implanted prosthesis; clean with entry into urinary tract; clean-contaminated
-Vascular

Usual Pediatric Dose for Peritonitis:

ISPD Recommendations:
PROPHYLAXIS:
Touch contamination: 125 mg/L intraperitoneally

Invasive dental procedures: 25 mg/kg IV as a single dose 30 to 60 minutes before procedure
Maximum dose: 1 g/dose

GI procedures: 25 mg/kg IV as a single dose, infused within 60 minutes before start of surgical procedure
Maximum dose: 2 g/dose

TREATMENT:
Continuous:
-Loading dose: 500 mg/L intraperitoneally
-Maintenance dose: 125 mg/L intraperitoneally

Intermittent: 20 mg/kg intraperitoneally once a day

Comments:
-For continuous therapy, the exchange with the loading dose should dwell for 3 to 6 hours; all subsequent exchanges during therapy should contain the maintenance dose.
-For intermittent therapy, the dose should be applied once a day in the long-dwell (unless otherwise specified).
-Current guidelines should be consulted for additional information.

Uses:
-As antibacterial prophylaxis in PD patients for:
---Touch contamination (instillation of PD fluid after disconnection of system, disconnection during PD)
---Invasive dental procedures (manipulation of gingival tissue or periapical region of teeth, or perforation of oral mucosa)
---High-risk GI procedures (esophageal stricture dilation, treatment of varices, endoscopic retrograde cholangiopancreatography, percutaneous endoscopic gastrostomy)
-For the treatment of PD-related peritonitis

What other drugs will affect cefazolin?

Other drugs may interact with cefazolin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about cefazolin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.05.

Date modified: June 01, 2017
Last reviewed: April 08, 2016

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