If you are a consumer or patient please visit this version. Cefazolin injection is a cephalosporin antibacterial indicated for preoperative prophylaxis. Limitations of Use: Use an alternative cefazolin product when lengthy surgical procedures require supplemental doses and when postoperative dosing is required. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Cefazolin injection and other antibacterial drugs, Cefazolin injection should be used only to prevent infections that are proven or strongly suspected to be caused by bacteria. Hypersensitivity to cefazolin or other cephalosporin antibacterial drugs, penicillins, or other beta-lactam drugs.
|Published (Last):||17 May 2010|
|PDF File Size:||17.37 Mb|
|ePub File Size:||17.44 Mb|
|Price:||Free* [*Free Regsitration Required]|
Send the page " " to a friend, relative, colleague or yourself. We do not record any personal information entered above. Parenteral first-generation cephalosporin.
The FDA-approved labeling recommends 1 to 1. Guidelines recommend cefazolin for 4 weeks for native valve endocarditis NVE and for 6 weeks for prosthetic valve endocarditis PVE caused by S. Cefazolin is recommended for 6 weeks for methicillin-susceptible staphylococcal NVE in penicillin-allergic nonanaphylactoid-type patients.
Use for in combination with gentamicin for first 2 weeks and rifampin for at least 6 weeks for methicillin-susceptible staphylococcal PVE. Guidelines recommend cefazolin as an alternate therapy for highly penicillin-susceptible streptococcal infections; treat for 4 weeks for native valve endocarditis NVE and for 6 weeks or prosthetic valve endocarditis PVE.
Cefazolin is also recommended as alternate therapy for penicillin-susceptible and certain resistant staphylococcal infections; treat for 4 to 6 weeks with or without gentamicin for the first 3 to 5 days for NVE and for at least 6 weeks with gentamicin for first 2 weeks and rifampin for PVE.
Perioperative antisepsis with povidone-iodine is recommended. The necessity of continuing topical antimicrobials postoperatively has not been established. For lengthy operations e. Where the occurrence of infection may be particularly devastating e.
Clinical practice guidelines suggest 2 g IV, and for patients weighing kg or more, 3 g IV. Intraoperative redosing 4 hours from the first preoperative dose and duration of prophylaxis less than 24 hours for most procedures is suggested by clinical practice guidelines. A longer prophylaxis duration of 48 hours for certain cardiothoracic procedures is controversial.
Cefazolin is FDA-approved for contaminated or potentially contaminated procedures, including vaginal hysterectomy and cholecystectomy in high-risk patients, as well as in surgical patients in whom infection at the operative site would present a serious risk e.
Clinical practice guidelines recommend cefazolin monotherapy for cardiothoracic, gastrointestinal, biliary tract, hernia repair, clean head and neck with prosthesis, neurosurgical, urogynecology, orthopedic, vascular, certain transplantation, and plastic surgery procedures.
Cefazolin is recommended as part of combination therapy for appendectomy, obstructed GI, colorectal, clean-contaminated head and neck, and urologic with prosthesis or clean-contaminated procedures. Repeat dose intraoperatively 4 hours after preoperative dose if surgery still in progress.
For mild infections, to mg IV or IM every 8 hours. For moderate to severe infections, to 1, mg IV or IM every 6 to 8 hours. The CDC does not recommend for the treatment of sexually transmitted epididymitis. Prophylaxis is recommended for at-risk cardiac patients who are undergoing dental procedures that involve manipulation of gingival tissue, manipulation of the periapical region of teeth, or perforation of the oral mucosa. Cardiac patients that are considered to be at highest risk include those with prosthetic cardiac valves or prosthetic material used for cardiac valve repair, previous infective endocarditis, select types of congenital heart disease CHD , and cardiac transplantation with valvulopathy.
Cefazolin is recommended as an alternative for patients with a low-risk penicillin allergy. Antibiotics administered for at least 4 hours before delivery have been found to be highly effective at preventing the transmission of Group B Streptococcus. Treat for 2 to 3 weeks depending on infecting organism and the patient's clinical status. Cefazolin is primarily eliminated by the kidneys and is not metabolized by the liver. No dosage adjustments are required in patients with hepatic impairment.
Intermittent hemodialysis For adult patients, mg to 1 g IV every 24 hours is recommended. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Storage: Reconstituted solutions are stable for 24 hours at room temperature or for 10 days if stored under refrigeration. Reconstituted solutions may range in color from pale yellow to yellow without a change in potency.
Storage: Bulk vials should be used within 4 hours of initial entry. Storage: ADD-Vantage vials should be reconstituted immediately before administration; however, the solution is stable for 24 hours at room temperature. Do not force thaw by immersion in water baths or by microwave irradiation. Storage: The thawed solution remains stable for 30 days under refrigeration or for 48 hours at room temperature.
Do not refreeze. Reconstitution Reconstitute powder with Sterile Water for Injection. Storage: Reconstituted solution is stable for 24 hours at room temperature or 10 days refrigerated. Generic: - Discard unused portion. Do not store for later use. Cefazolin may interfere with certain HPLC techniques and effect theophylline serum concentration measurements. A false-positive reaction for glucose in the urine has been observed in patients receiving cephalosporins, such as cefazolin, and using Benedict's solution, Fehling's solution, or Clinitest tablets for urine glucose testing.
However, this reaction has not been observed with glucose oxidase tests e. Patients with diabetes mellitus who test their urine for glucose should use glucose tests based on enzymatic glucose oxidase reactions while on cefazolin treatment. A positive direct Coombs test may develop in some patients.
In hematologic studies or in transfusion cross-matching procedures when antiglobulin tests are performed on the minor side or in Coombs test of newborns whose mothers received cefazolin before delivery, clinicians should keep in mind that a positive Coombs test may be due to the drug. Cefazolin does not treat viral infection e. Prescribing in the absence of a 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 antimicrobial resistance.
Patients should be told to complete the full course of treatment, even if they feel better earlier. Cefazolin is contraindicated in patients with cephalosporin hypersensitivity or cephamycin hypersensitivity. An anaphylactic response to both classes of drugs is possible. Cefazolin should be used cautiously in patients with hypersensitivity to penicillin.
The structural similarity between cefazolin and penicillin means that cross-reactivity can occur. Penicillins can cause a variety of hypersensitivity reactions ranging from mild rash to fatal anaphylaxis. Patients who have experienced severe penicillin hypersensitivity should not receive cefazolin. Cefazolin should be used with caution in patients with renal impairment or renal failure since the drug is eliminated via renal mechanisms. After an initial loading dose appropriate to the severity of the infection, lower doses should be employed for patients with reduced creatinine clearance; dosage adjustment recommendations are available for adult and pediatric patients.
Almost all antibacterial agents have been associated with pseudomembranous colitis antibiotic-associated colitis which may range in severity from mild to life-threatening. In the colon, overgrowth of Clostridia may exist when normal flora is altered subsequent to antibacterial administration. The toxin produced by Clostridium difficile is a primary cause of pseudomembranous colitis.
It is known that systemic use of antibiotics predisposes patients to development of pseudomembranous colitis. Consideration should be given to the diagnosis of pseudomembranous colitis in patients presenting with diarrhea following antibacterial administration.
Systemic antibiotics should be prescribed with caution to patients with inflammatory bowel disease such as ulcerative colitis or other GI disease. If diarrhea develops during therapy, the drug should be discontinued.
Following diagnosis of pseudomembranous colitis, therapeutic measures should be instituted. In milder cases, the colitis may respond to discontinuation of the offending agent.
In moderate to severe cases, fluids and electrolytes, protein supplementation, and treatment with an antibacterial effective against Clostridium difficile may be warranted. Products inhibiting peristalsis are contraindicated in this clinical situation. Practitioners should be aware that antibiotic-associated colitis has been observed to occur over two months or more following discontinuation of systemic antibiotic therapy; a careful medical history should be taken.
Cefazolin is classified as FDA pregnancy risk category B. Animal data reveal no teratogenic effects. There are, however, no adequate and well-controlled studies in pregnant women.
Because animal studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefazolin has not been studied for use during labor and delivery. Treatment should be given only if clearly needed. Cefazolin distributes into breast milk in low concentrations. The manufacturer recommends that cefazolin should be used with caution during breast feeding and the benefits versus risks should be considered.
AA rare potential complication in the nursing infant of a woman taking a cephalosporin is an alteration of gut flora that might result in diarrhea or other related complications e. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.
If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, healthcare providers are encouraged to report the adverse effect to the FDA. All cephalosporins, including cefazolin, may rarely cause hypoprothrombinemia and have the potential to cause bleeding. Cephalosporins which contain the NMTT side chain e. Cephalosporins should be used cautiously in patients with a preexisting coagulopathy e. No overall differences in safety or effectiveness of cefazolin were observed between the older adult and younger adults in clinical trials.
Cefazolin is excreted renally; because geriatric patients are more likely to have decreased renal function, care should be taken in dose selection and it may be useful to monitor renal function.
According to OBRA, use of antibiotics should be limited to confirmed or suspected bacterial infections. Antibiotics are non-selective and may result in the eradication of beneficial microorganisms while promoting the emergence of undesired ones, causing secondary infections such as oral thrush, colitis, or vaginitis.
Any antibiotic may cause diarrhea, nausea, vomiting, anorexia, and hypersensitivity reactions. Therefore, monitor for signs of clofarabine toxicity such as gastrointestinal toxicity e. If no alternative treatment options are available, closely monitor prothrombin time and other coagulation tests, and administer vitamin K as indicated. Postmarketing reports suggest that concomitant administration of high doses of rifampin and cefazolin may prolong the prothrombin time, leading to severe vitamin K-dependent coagulation disorders that may be life-threatening or fatal.
Isoniazid, INH; Rifampin: Moderate Avoid coadministration of rifampin and cefazolin in patients at increased risk of bleeding. Loop diuretics: Minor Nephrotoxicity associated with cephalosporins may be potentiated by concomitant therapy with loop diuretics. Clinicians should be aware that this may occur even in patients with minor or transient renal impairment.
Oral Contraceptives: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora.
Generic Name: cefazolin sodium Dosage Form: for Injection. Medically reviewed by Drugs. Last updated on Nov 21, The Ancef brand name has been discontinued in the U. If generic versions of this product have been approved by the FDA, there may be generic equivalents available.