Generic Name: cefazolin
Brand Names: Ancef, Kefzol (discontinued brand)
Drug Class: Cephalosporins, 1st Generation
What is cefazolin, and what is it used for?
Cefazolin is a broad spectrum antibiotic used to treat bacterial infections. Cefazolin is active against many gram-positive and gram-negative bacteria, however, it is a first generation cephalosporin and many strains have developed resistance to it. Gram-positive and gram-negative bacteria are structurally different, identified by the Gram stain lab test. Gram-negative bacteria have an additional membrane outside the cell wall that gram-positive bacteria lack.
Cefazolin kills bacteria by inhibiting the synthesis of peptidoglycan, a vital component that provides stability to the bacterial cell wall. Cephalosporins are beta-lactam antibiotics that contain a beta-lactam ring in their chemical structure. Beta-lactam is a compound that targets and blocks penicillin-binding proteins, enzymes that are essential for the biosynthesis of peptidoglycan. Bacteria develop resistance to beta-lactam antibiotics by producing beta-lactamases, enzymes that cleave the beta-lactam rings in the antibiotics and destroy them. Organisms susceptible to cefazolin include:
- Gram-positive bacteria: Staphylococcus aureus (methicillin-susceptible strains, including those producing penicillinases), Staphylococcus epidermidis, Group A beta-hemolytic streptococci and other strains of streptococci (many strains of enterococci are resistant), Streptococcus pneumoniae
- Gram-negative bacteria: Escherichia coli, Klebsiella species, Proteus mirabilis, Haemophilus influenzae, Enterobacter aerogenes
Cefazolin is used to treat the following bacterial infections:
- Respiratory tract infections
- Urinary tract infections
- Skin and skin structure infections
- Biliary tract infections
- Bone and joint infections
- Genital infections
- Perioperative prophylaxis
Off-label uses include:
- Bacterial keratitis (administered in the eye)
- Peritonitis treatment (in peritoneal dialysis patients)
- Streptococcus (group B) maternal prophylaxis for prevention of neonatal disease
- Toxic shock syndrome
- Do not administer cefazolin to patients with known hypersensitivity to cephalosporin group of antibiotics
- Use cefazolin with caution in patients with a history of penicillin allergy because cross-hypersensitivity among penicillin and beta-lactam antibiotics may occur
- Endocarditis prophylaxis recommended only for high-risk patients, per American Heart Association (AHA) guidelines
- Use of nearly all antibacterial agents including cefazolin can lead to Clostridium difficile overgrowth and associated diarrhea or colitis
- Prolonged or repeated use may result in bacterial and fungal overgrowth of non-susceptible organisms
- Use of 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 development of drug-resistant bacteria
- Use with caution in patients with seizure disorders; high doses are associated with increased risk of seizures
- Cefazolin may increase blood clotting time, particularly in patients with impaired kidney or liver function, poor nutritional state, patients on prolonged antimicrobial therapy and patients previously stabilized on anticoagulant therapy
What are the side effects of cefazolin?
Common side effects of cefazolin include:
- Injection site reactions such as:
- Low blood pressure (hypotension)
- Fainting (syncope)
- Abdominal cramps and pain
- Loss of appetite (anorexia)
- Gas (flatulence)
- Oral candida yeast infection (candidiasis)
- Oral ulcers
- Clostridium difficile colitis
- Clostridium difficile associated diarrhea (CDAD)
- Anal itching
- Skin reactions including:
- Serum sickness
- Severe allergic reaction (anaphylaxis)
- Vaginal inflammation (vaginitis)
- Vulvovaginal candidiasis
- Vulvovaginal pruritus
- Increase in liver enzymes ALT and AST
- Increase in alkaline phosphatase level
- Liver inflammation (hepatitis)
- Increased blood urea nitrogen (BUN)
- Increase in serum creatinine
- Acute kidney inflammation
- Renal failure syndrome
- Weakness (asthenia)
- Drug fever
- Blood disorders such as:
- Low leukocyte count (leukopenia)
- Low neutrophil count (neutropenia)
- Low platelet levels (thrombocytopenia)
- Elevated platelet levels (thrombocythemia)
- Elevated eosinophil levels (eosinophilia)
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.
Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
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What are the dosages of cefazolin?
Powder for Injection
- 0.5-1 g intravenous (IV) every 6-8 hours
Mild Infections with Gram-Positive Cocci
- 250-500 mg IV every 8 hours
- 1-2 g IV every 8 hours for 4-7 days
Uncomplicated Urinary Tract Infection
- 1 g IV every 12 hours
Preparation for Surgery
Prophylaxis against infection
- Preoperatively: 1-2 g intravenous/intramuscular (IV/IM) within 1 hour before procedure (may be repeated in 2-5 hours intraoperatively)
- Postoperatively: 0.5-1 g IV every 6-8 hours for 24 hours
- Cardiac procedures, hysterectomy, oral or pharyngeal procedures, craniotomy, joint replacement, thoracic procedures, arterial procedures, amputation, traumatic wounds; high-risk esophageal, gastroduodenal, or biliary tract procedures: 1-2 g IV
- Colorectal procedures: 1-2 g IV plus metronidazole 0.5 g IV
- High-risk cesarean section, 2nd trimester abortion: 1 g IV
- Ophthalmic procedures: 100 mg subconjunctivally
- 1 g IV/IM 30-60 minutes before procedure
- American Heart Association (AHA) guidelines: Endocarditis prophylaxis recommended only for high-risk patients
Bacterial Keratitis (Off-label)
- 1 drop instilled into affected eye(s) every 1-2 hours; typically alternated every other hour with antibiotic providing gram-negative coverage (e.g., tobramycin)
- Extemporaneous compounded fortified cefazolin 50 mg/mL
- Dilute 500 mg parenteral cefazolin powder in sterile water to form 10 mL solution
- Store refrigerated; preparation expires in 7 days
- CrCl 35-54 mL/min: Give full dose at intervals longer than 8 hours
- CrCl 10-35 mL/min: Give therapeutic dose every 12 hours
- CrCl 10 mL/min or less: Give therapeutic dose every 24 hours
- Not studied
Infections with Gram-Positive Cocci
Neonates (younger than 28 days)
- Younger than 7 days: 40 mg/kg/day IV/IM divided every 12 hours
- Older than 7 days, weight less than 2 kg: 40 mg/kg/day IV/IM divided every 12 hours
- Older than 7 days, weight greater than 2 kg: 60 mg/kg/day IV/IM divided every 8 hours
Infants & children
- 25-100 mg/kg/day IV/IM divided every 6-8 hours; not to exceed 6 g/day
- 50 mg/kg IV/IM 30-60 minutes before procedure; not to exceed 1 g
- AHA guidelines: Endocarditis prophylaxis recommended only for high-risk patients
- Children 3 months and older: 150 mg/kg/day IV/IM divided every 8 hours (moderate to severe infections, methicillin susceptible S. aureus preferred
- Cefazolin 2 g for Injection USP and Dextrose Injection USP are not recommended for use in pediatric patients; to avoid unintentional overdose, 1 g cefazolin for Injection USP and dextrose Injection USP should only be used in pediatric patients who require entire contents of 1 g dose and not any fraction of it
- There are no dosing recommendations for pediatric patients for perioperative prophylaxis or for pediatric patients with renal impairment
What drugs interact with cefazolin?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Cefazolin has no known severe interactions with other drugs.
- Serious interactions of cefazolin include:
- antithrombin alfa
- antithrombin III
- BCG vaccine live
- cholera vaccine
- typhoid vaccine live
- Moderate interactions of cefazolin include:
- bazedoxifene/conjugated estrogens
- dienogest/estradiol valerate
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
- sodium picosulfate/magnesium oxide/anhydrous citric acid
- Mild interactions of cefazolin include:
- aspirin/citric acid/sodium bicarbonate
- ketorolac intranasal
- pyridoxine (Antidote)
- rose hips
- willow bark
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information.
Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Available data do not show any evidence of fetal harm with the use of cefazolin during pregnancy and is acceptable for use in pregnant women.
- Cefazolin is one of the recommended antibiotics that may be used prior to vaginal delivery in patients at high risk for endocarditis. Cefazolin may also be used prior to Cesarean deliveries.
- Cefazolin is present in very low concentrations in the milk of nursing mothers; use with caution.
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Cefazolin is a broad spectrum antibiotic used to treat bacterial infections, including respiratory tract infections, urinary tract infections, skin infections, biliary tract infections, bone and joint infections, genital infections, and others. Common side effects of cefazolin include injection site reactions, low blood pressure (hypotension), fainting (syncope), abdominal cramps and pain, loss of appetite (anorexia), diarrhea, gas (flatulence), heartburn, oral candida yeast infection (candidiasis), and others.
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An eye infection may bring about the following changes in the eye: A pink tint in the whites of the eye, swollen red or purple eyelids, crusty lashes or lids, and/or discharge of fluids which may be yellow, green or clear.
How Can I Treat a Yeast Infection While Pregnant?
Vaginal yeast infections are fungal infections that cause irritation and vaginal discharge. You can treat a vaginal yeast infection while pregnant with vaginal creams or suppositories, non-prescription medications, or medications that have been proven safe and effective in pregnant women.
Sinus Infection vs. Allergies
Both sinus infections and allergies (allergic rhinitis) cause symptoms such as runny or stuffy nose and fatigue. Sinus infection (known as sinusitis) is inflammation of the sinuses, caused by infection from bacteria, viruses, and/or fungi (molds). Allergic rhinitis occurs when certain allergies cause nasal symptoms. When a person with allergies breathes in an allergen, such as pollen, dust, or animal dander, symptoms such as runny or stuffy nose, itching, sneezing, and fatigue occur.
How Do You Know if You Have a Sinus Infection (Sinusitis) or COVID-19 Coronavirus?
Learn how the signs and symptoms of a sinus infection are different from those caused by COVID-19.
What Is the Best Treatment for Urinary Tract Infection?
In most cases, the best treatment for a urinary tract infection (UTI) is a course of antibiotics. Which antibiotics are prescribed depend on the type of bacteria responsible.
Is It a Cold or a Sinus Infection?
A sinus infection, also known as sinusitis or rhinosinusitis, is a condition in which the delicate membranes that line the sinuses may get swollen and become red. A cold or common cold is a viral infection. It affects the upper respiratory system, which includes the nose, mouth, throat, and lungs.
How to Get Rid of a Sinus Infection Fast
The sinuses are air-filled cavities that surround the nose and drain into the nose. They are present in the forehead, the cheeks and near the eyes. Treatment for sinus infections includes over-the-counter pain relievers, decongestants, antibiotics, humidifiers, nasal irrigation, steam inhalation, rest, hydration and warm compresses.
How Serious Is a Staph Infection?
A Staphylococcus or staph infection is caused by a germ that may be found in 30% of healthy people’s noses. Most of the time, these bacteria do not cause any health problems. However, in some people, it may cause skin and other organ infections. Most often, staph causes minor skin infections such as a boil. However, if it enters into your bloodstream and other organs, it may turn out to be deadly.
How Does a Woman Get a Urinary Tract Infection?
Urinary tract infections (UTIs) occur more frequently in women because they have a shorter urethra, making it easier for bacteria from the anus to travel to the area.
What Is the Fastest Way to Get Rid of a Sinus Infection?
Learn what medical treatments can help ease your sinus infection symptoms and speed up your recovery.
How Does COVID-19 Infection Affect the Placenta?
The placenta is the supply chain and waste disposal for the baby in your womb. After studying a few second-trimester and hundreds of third-trimester placentas from women with Covid-19, researchers determined the virus causes significant destruction within this vital organ.
How Do I Check Myself for a Yeast Infection?
If you suspect you have a vaginal yeast infection, you may try an at-home vaginal pH test; however, this test will only help you rule out other infections.
Can I Have COVID-19 and Fungal Infection at the Same Time?
One of those challenges is that bacterial and fungal infections can occur alongside COVID-19, especially in people whose cases are severe enough to put them in the ICU or who have existing comorbidities like diabetes or HIV.
How Can You Tell if You Have a Kidney Infection?
Kidney infection or pyelonephritis is a serious medical condition in which there is an infection of one or both the kidneys.
What Is the Most Common Cause of Urinary Tract Infection?
E. coli bacteria are the most common cause of urinary tract infection (UTI).
Urinary Tract Infection or Urinary Infection
The urinary system of your body includes two kidneys, two tubes (ureters), a urine sac (bladder) and an opening to expel the urine from the body (urethra). An infection of this system due to germs is called a urinary tract infection (UTI). UTI may be treated with antibiotics, especially if a kidney infection is involved.
How Do You Know If You Have a Kidney Infection?
A kidney infection is a potentially life-threatening illness if left untreated. Learn the signs of a kidney infection, what causes it, how doctors diagnose it, and what you can do to treat a kidney infection.
How Do You Know if You Have a Urinary Tract Infection?
Urinary tract infections can occur in both women and men. Learn the signs of urinary tract infection, what causes it, how doctors diagnose it, and what you can do to treat it.
Staph Infection Causes
Staph or Staphylococcus is a group of bacteria that is found over the skin of most individuals. Staph bacteria usually live inside the nose, but they do not cause an infection. Staph infections may turn deadly if the bacteria invade deeper into the body, entering the bloodstream, joints, bones, lungs, or heart.
How Do You Get Rid of a Urinary Tract Infection (UTI)?
Learn what medical treatments can help treat your urinary tract infection symptoms and help you manage this condition.
What Causes a Urinary Tract Infection in a Child?
What is a urinary tract infection, and how does it affect children? Learn the signs of urinary tract infection in kids, what causes it, and what you can do to treat it.
Treatment & Diagnosis
- Bladder Infection
- Urinary Tract Infection (UTI)
- Helicobacter pylori (H. pylori) Infection
- Giardiasis (Giardia Lamblia Infection)
- Sinus Infection (Sinusitis)
- Upper Respiratory Infection
- MRSA Infection
- Middle Ear Infection (Otitis Media)
- Vaginal Yeast Infection
- Kidney Infection (Pyelonephritis)
- Inner Ear Infection (Otitis Interna)
- Respiratory Syncytial Virus (RSV) Infection
- Group B Strep Infection
- Rotavirus Infection
- Group A Streptococcus Infection
- Urinary Tract Infections in Children
- Urinary Tract Infection FAQs
- Yeast Infection FAQs
- MRSA FAQs
- Strep Streptococcal Throat Infection FAQs
- Ear Infection FAQs
- Pregnancy Planning - Vaginal Infection Can Cause Premature Birth
- Kidney Infections During Pregnancy
- Is It Easier to Get Staph Infection When You've Had it Before?
- What Causes Yeast Infections (Vaginitis)?
- What Is the Difference Between a Bladder Infection vs. UTI?
- How Do You Get Staph Infection?
- What Causes an Ear Infection?
- How Do You Get an Ear Infection?
- How to Get Rid of a Staph Infection
- Does Stress Cause Yeast Infection?
- Does Douching Cause Yeast Infections?
- Is there Over-the-Counter Ear Infection Medicine?
- Urinary Tract Infection (UTI) Symptoms
- E. coli Infection Facts
- Urinary Tract Infection (UTI) Treatment
Infectious Disease Resources
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