Drug Guide

Generic Name

Cefazolin Sodium

Brand Names Ancef, Kefzol, Ancef In Sodium Chloride 0.9% In Plastic Container, Ancef In Dextrose 5% In Plastic Container, Cefazolin And Dextrose, Cefazolin In Dextrose

Classification

Therapeutic: Antibiotic, First-generation cephalosporin

Pharmacological: Beta-lactam antibiotic

FDA Approved Indications

Susceptible bacterial infections such as skin and skin structure infections, respiratory tract infections, urinary tract infections, bone and joint infections, and septicemia.

Mechanism of Action

Cefazolin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.

Dosage and Administration

Adult: 1- 2 grams IV or IM every 8 hours, adjusted according to infection severity and site.

Pediatric: 50-100 mg/kg/day divided every 8-12 hours depending on severity and child's age.

Geriatric: Use with caution; dosage adjustment based on renal function.

Renal Impairment: Adjust dose based on creatinine clearance; typical adjustment involves extending dosing intervals.

Hepatic Impairment: No specific adjustment necessary.

Pharmacokinetics

Absorption: Poorly absorbed from the gastrointestinal tract; administered parenterally.

Distribution: Widely distributed, including to most body tissues and fluids.

Metabolism: Minimal hepatic metabolism.

Excretion: Approximately 80% excreted unchanged in urine.

Half Life: 1.8 hours.

Contraindications

Known hypersensitivity to cephalosporins or other beta-lactam antibiotics.

Precautions

Use cautiously in patients with a history of allergic reactions to penicillins.
Monitor renal function during therapy, especially in patients with pre-existing renal impairment.

Adverse Reactions - Common

Diarrhea (Common)
Nausea, vomiting (Common)
Rash, urticaria (Common)

Adverse Reactions - Serious

Anaphylaxis (Rare)
Clostridioides difficile-associated diarrhea (Uncommon)
Hepatotoxicity (Rare)

Drug-Drug Interactions

Aminoglycosides (enhanced nephrotoxicity),
Probenecid (increases cefazolin levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal function, liver function, and signs of allergic reactions.

Diagnoses:

Risk for allergic reaction
Impaired renal function

Implementation: Administer IV or IM as prescribed; ensure proper reconstitution and handling.

Evaluation: Assess for resolution of infection symptoms and monitor for adverse reactions.

Patient/Family Teaching

Complete full course of therapy even if symptoms improve.
Report any allergic reactions immediately.
Inform about possible gastrointestinal side effects and signs of infection or superinfection.

Special Considerations

Black Box Warnings:

Allergy to penicillins or other beta-lactams may increase the risk of allergic reactions.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: May cause false-positive result in Coombs' test and urine glucose testing.

Overdose Management

Signs/Symptoms: Signs of overdose may include confusion, nephrotoxicity, or seizures.

Treatment: Supportive care, hydration, and possible dialysis in severe cases.

Storage and Handling

Storage: Store at 20-25°C (68-77°F), protected from light.

Stability: Stable for 24 hours at room temperature after reconstitution; refrigerate if not used immediately.