Cefazolin

UNCONTROLLED WHEN PRINTED

Introduction

1st generation cephalosporin, moderate spectrum antibiotic active against staphylococci, streptococci, and some Gram-positive anaerobes. It has poor activity against Gram-negative bacilli.
Interferes with bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell lysis and death.
Reduces incidence of infection in fractures and surgical procedures.
Peak action around 90 minutes. Excreted unchanged in the urine, with 80% excreted in first 24 hours.

Indications

Antibiotic prophylaxis for;

Open fractures
Significant wounds that are grossly contaminated and cannot be cleaned
Traumatic pneumothorax that requires pleural decompression by finger thoracostomy

Contraindications

History of allergy to cephalosporins or of immediate or severe hypersensitivity to penicillins

Precautions / Notes

Do not delay transport for the administration of antibiotics
The safety of cefazolin for use during pregnancy and breastfeeding has not been established (Category B1), the benefit in this scenario outweighs the risk
Increased risk of bleeding due to effect on clotting factors, monitor INR in patients on anticoagulants
Cefazolin should not be given via the same administration line as any blood products
Intramuscular administration (IM) route not to be used

Management

Adult:

Paediatric:

Special Considerations

References

Presentation

2g powder for injection

Dilution:

Reconstitute 2g powder vial with 19mL of water for injection in 20mL syringe to make a concentration of 100mg/ml.

Colour assist:

Directorate

Clinical Services

Responsible Manager

Head of Clinical Services

Date of Issue

Date of Expiry