Adult Dosing
Bacterial infections caused by susceptible bacteria
- Mild infections: 250-500 mg IM/IV q8 hrs
- Moderate to severe infections: 500 mg to 1 g IM/IV q6-8 hrs
- Severe life threatening infections (e.g. endocarditis, septicemia): 1 to 1.5 g IM/IV q6 hrs [Max: 12 g/day]
Endocarditis Prophylaxis
- 1 g IV 30-60 minutes before procedure
Perioperative Prophylaxis
- 1 g IV 30-60 minutes before procedure
- Lengthy surgical procedures ( >2 hrs): 500 mg to 1 g IV during surgery)
- Post Surgery: 500 mg to 1 g IV q6-8 hrs for 24 hrs
Prevention of perinatal Group B Streptococcal disease (GBS) (Not FDA approved)
- 2 g IV followed by 1 g IV q8 hrs until delivery
Orbital cellulitis [Non-FDA Approved]
Pediatric Dosing
Bacterial infections caused by susceptible bacteria
Child > 1mo
- Mild to moderate infections: 25 to 50 mg/kg/day IM/IV div q6-8 hrs. Max: 6 g/day
- Severe infections: 100 mg/kg/day IM/IV div q6-8 hrs. Max: 6 g/day
Neonates (Not FDA approved)
7 days: 40 mg/kg/day IM/IV div q12 hrs- >7 days and 2 kg: 40 mg/kg/day IM/IV div q12 hrs
- >7 days and >2 kg: 60 mg/kg/day IM/IV div q8 hrs
Endocarditis Prophylaxis
- 50 mg/kg IM/IV 30-60 minutes before procedure [Max: 1 g/dose]
Prevention of perinatal Group B Streptococcal disease (GBS) (Not FDA approved)
- 2 g IV followed by 1 g IV q8 hrs until delivery
Orbital cellulitis (> 1 month) [Non-FDA Approved]
- 40-100 mg/kg/day IV divided q6-8h
[Outline]
Renal Dose Adjustment (Based on CrCl)
Adults
55 mL/min : Give usual dose- 35-54 mL/min: Give usual dose q8 hrs
- 11-34 mL/min: Give usual dose x 1, then give 50% of usual dose q12 hrs
- 10 mL/min: Give usual dose x 1, then give 50% of usual dose q18-24 hrs
Child
- 40-70 mL/min: Give usual dose x 1, then give 60% of usual daily dose q12 hrs
- 20-39 mL/min: Give usual dose x 1, then give 25% of usual daily dose q12 hrs
- 5-19 mL/min: Give usual dose x 1, then give 10% of usual daily dose q24 hrs
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Prior to initiating therapy determine whether the patient has had previous hypersensitivity reactions to cefadroxil, cephalosporins, penicillins, or other drugs
- Cautiously administer in penicillin sensitive patients as cross sensitivity may occur
- Suspend therapy on occurrence of an allergic reaction and treat accordingly if serious acute hypersensitivity takes place
- Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of cefazolin
- Careful clinical observation and appropriate laboratory studies should be made prior to and during therapy in patients with known or suspected renal impairment
- Use of therapy in strongly suspected bacterial infection or a prophylactic indication may increase the risk of the development of drug-resistant bacteria
- Careful observation is needed in prolonged use of therapy because prolonged use may result in the overgrowth of non- susceptible organism. Appropriate measures should be taken if superinfection occurs during therapy
- Administer cautiously in patients with hx of GI disease particularly colitis
- Cefazolin may be associated with a fall in prothrombin activity. Prothrombin time should be monitored in patients at risk and exogenous vitamin K administered as indicated
- Cefazolin for Injection USP and Dextrose Injection USP should be prescribed with caution in patients with overt or known subclinical diabetes mellitus or carbohydrate intolerance for any reason
Cautions: Use cautiously in
- Renal impairment
- Hypersensitivity to penicillin
- Hx of antibiotic associated colitis
- Hx of GI disease
- Seizure disorder
Pregnancy Category:B
Breastfeeding: Limited information indicates that maternal doses of cefazolin up to 2 grams produce low levels in milk that are not expected to cause adverse effects in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 31 December 2010 ). This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 ).Manufacturer advises caution while administering to a nursing woman.
