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Cefazolin

Uses|Precautions & warnings|Side effects|Interactions|Dosage

Uses

What is cefazolin used for?

Cefazolin (also spelled cephazolin) is part of a class of antibiotics known as cephalosporins, specifically a first-generation cephalosporin. Cephalosporins are chemically related to penicillin, and work by binding to penicillin-binding proteins (PBPs) that are embedded on certain bacterial cell walls. This binding prevents normal crosslinking and results in a weakened cell wall that ruptures and kills the bacteria.

Cephalosporins have the same mechanism as penicillin, however, have enhanced resistance against β-lactamases.

Cefazolin is a broad-spectrum antibiotic mainly indicated for:

  • Skin and soft-tissue infections
  • Acute uncomplicated urinary tract infections (UTIs)
  • Pneumonia
  • Prophylaxis for surgical infections

The antimicrobial spectrum of activity of cefazolin includes:

Gram-positive bacteria

  • Staphylococcus spp

Including:

  • methicillin-susceptible Staphylococcus aureus (MSSA)
  • coagulase-negative Staphylococci
  • Streptococcus spp

Including:

  • Streptococcus pneumoniae

Aerobic Gram-negative

  • Escherichia coli
  • Moraxella catarrhalis
  • Klebsiella pneumoniae
  • Proteus mirabilis

How should I take cefazolin?

Cefazolin is available as a parenteral powder for injection. This medication requires reconstitution with an appropriate diluent prior to administration. It should be administered by a licensed health professional.

How do I store cefazolin?

This drug should be stored at room temperature (20-25°C) and be protected from light and moisture. Always check the label before using this product. For safety, keep out of the reach of children and pets.

Do not use if the printed expiration date has passed, the product seal has been broken, or the product has changed in color, odor, or consistency. Keep reconstituted solutions in the refrigerator (<20°C) for up to 10 days. Do not freeze this product.

Do not dispose of this product by pouring it down the drain, toilet, or into the environment. Ask your pharmacist regarding the proper way and location of disposal.

Precautions &amp; warnings

What should I know before using cefazolin?

Before using this medication, inform your doctor if:

  • You have ever had an allergic reaction to cefazolin or other cephalosporins
  • You have a history of allergy to other medications, food, or other substances
  • You are taking other medications
  • You have underlying health conditions

Is it safe during pregnancy or breastfeeding?

This drug is a pregnancy category B drug. There are no adequate and well-controlled studies using cefazolin in pregnant women, however, animal studies show no risk to the fetus. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as determined by your doctor.

This drug is excreted in breast milk. This drug should be used while breastfeeding only if the potential benefit justifies the potential risk to the child, as determined by your doctor.

Side effects

What side effects can occur when using cefazolin?

All drugs have the potential to elicit side effects even with normal use. Many side effects are dose-related and will resolve when it is adjusted or at the end of therapy.

Potential side effects while using this drug include:

  • Nausea, vomiting
  • Diarrhea
  • Colitis
  • Mild allergic reaction

Rare, serious adverse reactions:

  • Hepatitis
  • Nephrotoxicity
  • Blood abnormalities
  • Anaphylactic reaction
  • Convulsions

You may experience some, none, or other side effects not mentioned above. If you experience serious adverse reactions, you must stop taking the drug immediately. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.

Interactions

What drugs may interact with cefazolin?

This drug may interact with other medications. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Known drugs and associated interactions with this medication include:

  • Warfarin
    • Enhanced anticoagulant effect
  • Sodium picosulfate
    • Decreased therapeutic effect of this drug
  • BCG and typhoid vaccine
    • Decreased therapeutic effect of these vaccines
  • Fosphenytoin and phenytoin
    • Decreased protein binding of these drugs
  • Probenecid
    • Decreased clearance of cefazolin
  • Aminoglycosides
    • Increased nephrotoxicity

This drug is incompatible with the following:

  • Aminoglycosides
  • Amphotericin B cholesteryl sulfate complex
  • Caspofungin
  • Idarubicin
  • Pemetrexed
  • Pentamidine
  • Vinorelbine
  • Amiodarone
  • Anakinra
  • Cisatracurium
  • Doxapram
  • Hetastarch in NS
  • Hydromorphone
  • Pantoprazole
  • Promethazine
  • Vancomycin

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

Does food or alcohol interact with cefazolin?

This drug can be taken with or without meals, as there is no notable interaction. Do not take this medication with alcohol as it may induce a disulfiram-like reaction, including symptoms such as nausea, vomiting, flushing, dizziness, chest and abdominal discomfort, and hangover-like symptoms.

Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

What health conditions may interact with cefazolin?

This drug should be taken with caution if you have any of the following conditions or risk factors:

  • History of hypersensitivity to penicillins
  • Renal impairment
  • GI disease
    • Colitis
    • Clostridium difficile-associated diarrhea
  • Seizure disorder

Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using cefazolin.

What is the dose of cefazolin for an adult?

All doses are to be given by deep IM injection or slow IV injection over 3-5 min, or intermittent or continuous IV infusion.

For treating susceptible infections

  • Mild: 0.25-0.5 g every 8 hours.
  • Moderate-to-severe: 0.5-1 g every 6 to 8 hours
  • Severe or life-threatening: 1-1.5 g every 6 hours
  • Maximum dose: 12 g per day

For treating acute uncomplicated urinary tract infections

  • Administer 1 g every 12 hours
  • Maximum dose: 12 g per day

For treating pneumonia

  • Administer 500 mg every 12 hours
  • Maximum dose: 12 g per day

Prophylaxis for surgical infections

  • Administer 1 g given 30-60 min prior to surgery
  • Administer 0.5-1 g during surgery for lengthy procedures
  • Administer 0.5-1 g every 6 to 8 hours after surgery for 24 hours or up to 5 days

Dose adjustment for renal impairment

Creatinine clearance (CrCl)

  • < 10: reduce the dose to half the normal dose and administer every 18 to 24 hours
  • 11-34: reduce the dose to half the normal dose and administer every 12 hours
  • 35-54: administer the normal dose at intervals of 8 hours or more

What is the dose of cefazolin for a child?

All doses are to be given by deep IM injection or slow IV injection over 3-5 min, or intermittent or continuous IV infusion.

For treating susceptible infections

  • Ages over 1 year: administer 25-50 mg/kg daily in 3 or 4 divided doses
  • Maximum dose: 100 mg/kg in divided doses (for severe infections)

For treating cute uncomplicated urinary tract infections

  • Ages over 1 year: administer 25-50 mg/kg daily in 3 or 4 divided doses
  • Maximum dose: 100 mg/kg in divided doses (for severe infections)

For treating pneumonia

  • Ages over 1 year: administer 25-50 mg/kg daily in 3 or 4 divided doses
  • Maximum dose: 100 mg/kg in divided doses (for severe infections)

How is cefazolin available?

This drug is available in the following brands, dosage forms, and strengths:

  • Cefavex powder for injection 1 g
  • Cefazole powder for injection 1 g (with 10 mL diluent)
  • Cizo powder for injection 250 mg, 500 mg, 1 g (with 5 mL diluent)
  • Fazlin powder for injection 1 g
  • Fonvicol powder for injection 1 g
  • Fazonil powder for injection 500 mg (with 5 mL diluent), 1 g (with 10 mL diluent)

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of this drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose. Avoid missing doses to prevent antibiotic resistance and treatment failure.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Cefazolin. https://mims.com/philippines/drug/info/cefazolin?mtype=generic. Accessed July 20, 2020

Cefazolin. http://www.antimicrobe.org/drugpopup/Cefazolin.pdf. Accessed July 20, 2020

Cephalosporin-induced disulfiram-like reaction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968840/. Accessed July 20, 2020

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Medical reviewed by Stephanie Nicole Nera, RPh, PharmD
Written by Stephanie Nicole Nera, RPh, PharmD
Updated Jul 31, 2020
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