Cefazolin

DEA Class; Rx

Common Brand Names; Ancef, Kefzol

Indicated for the treatment of upper respiratory tract infections, skin and skin structure infections, and biliary tract infections.

Documented hypersensitivity

• Anorexia
• Diarrhea
• Eosinophilia
• Fever
• Increased transaminases
• Leukopenia
• Nausea and vomiting
• Neutropenia
• Oral candidiasis
• Pain at injection site
• Phlebitis
• Pseudomembranous colitis
• Seizure
• Stevens-Johnson syndrome
• Thrombocytopenia
• Thrombocytosis
• Transient elevation of hepatic enzymes
• Vaginitis
• Immune system disorders: Serum sickness-like reaction
• Renal and urinary disorders: Acute tubulointerstitial nephritis
• Skin and subcutaneous tissue disorders: Acute generalized exanthematous pustulosis (AGEP)

Endocarditis prophylaxis recommended only for high-risk patients, per AHA guidelines

Prolonged treatment, hepatic or renal disease, or nutritional deficiency may be associated with increased international normalized ratio (INR)

Use with caution in patients with seizure disorder (high levels are associated with increased risk of seizures); seizures may occur, particularly in patients with renal impairment when dosage is not reduced appropriately; dose must be adjusted in severe renal insufficiency (high doses may cause CNS toxicity); discontinue if seizures occur or make appropriate dosage adjustments in patients with renal impairment; continue anticonvulsant therapy in patients with known seizure disorders

Prescribing cefazolin injection in absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases risk of development of drug-resistant bacteria

As with other antimicrobials, prolonged use of cefazolin injection may result in overgrowth of nonsusceptible microorganisms; repeated evaluation of the patient’s condition is essential; should superinfection occur during therapy, appropriate measures should be taken

Therapy may result in a false-positive reaction with glucose in urine when using glucose tests based on Benedict’s copper reduction reaction that determine amount of reducing substances like glucose in urine; it is recommended that glucose tests based on enzymatic glucose oxidase be used

Hypersensitivity reactions, including anaphylaxis, reported with administration of dextrose-containing products; these reactions have been reported in patients receiving high concentrations of dextrose (i.e. 50% dextrose); reactions have been reported when corn-derived dextrose solutions were administered to patients with or without a history of hypersensitivity to corn products

As with other dextrose-containing solutions, cefazolin injection should be prescribed with caution in patients with overt or known subclinical diabetes mellitus or carbohydrate intolerance for any reason

Available data from published prospective cohort studies, case series and case reports over several decades with cephalosporin use, including cefazolin, in pregnant women have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; drug crosses the placenta

Data from published literature report that cefazolin is present in human milk, but not expected to accumulate in a breastfed infant; there are no data on effects of drug on breastfed child or on milk production