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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:

  • 2g IV only, administered over 3-5 minutes

Paediatric:

  • 30mg/kg IV (maximum of 2g) administered over 3-5 minutes
Special Considerations
  • Allergy & Anaphylaxis
  • Nausea & Vomiting
  • Rash
  • Pain and inflammation at injection site

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