Cefazolin
General Information
Do NOT use if patient has a history of severe penicillin allergy. If in doubt, discuss with Micro/ID
Restricted formulary antimicrobial: As per guidelines. Other indications must be recommended by a Micro/ID consultant or registrar.
AWaRe antibiotic classification: 'Access'. Use as per guidelines.
For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF.
Drug Safety Updates
Caution: Prothrombin time, INR and APTT may increase on cefazolin treatment courses, please monitor. For more information see Cefazolin associated coagulation disorders
Dosing
|
Intravenous dose |
|
|
Standard dose |
1g TDS |
|
Severe infection or weight greater than 90kg |
2g TDS |
Cefazolin (with probenecid) can also be given under AHAH for certain indications. For more information, see Hospital at Home Patients section.
Obesity
Dosing for cefazolin should be at the upper end of recommended ranges, particularly for morbidly obese patient with severe infections, considering patient’s renal function.
Renal and hepatic impairment
Renal impairment
|
Creatinine Clearance (mL/min)* |
Intravenous dose |
|
35 or more |
No adjustment |
|
11-34 |
Half normal dose every 12 hours |
|
10 or less |
Half normal dose every 24 hours |
|
PD (dialysed) |
500mg every 12 hours |
|
HD/HDF/High Flux (dialysed) |
1g daily or dose after each dialysis session, according to number of days between sessions e.g. mon-wed-fri dialysis is 2g-2g-3g |
*dose ranges use creatinine clearance, rather than eGFR
Hepatic impairment
No dose adjustment required
References
- Noridem Enterprises Ltd. Cefazolin 1g Powder for solution for injection/infusion summary of product characteristics. Medicines and Healthcare Products Regulatory Agency [Internet]. 2023 [cited 2025 April 1]. Available from: https://products.mhra.gov.uk/substance/?substance=CEFAZOLIN%20SODIUM
- The Renal Drug Database. Cefazolin [Internet]. 2023 [cited 2025 April 1]. Available from: https://www.renaldrugdatabase.com/s/article/CEFAZOLIN-SODIUM
- Meng L, Mui E, Ha DR, Stave C, Deresinski SC, Holubar M. Comprehensive guidance for antibiotic dosing in obese adults: 2022 update. Pharmacotherapy. 2023; 43(3):177-259.
- UK Clinical Pharmacy Association. Drug dosing in extremes of body weight in critically ill patients, 1st edition [Internet]. 2013 [cited 2025 April 1]. Available from: https://ukclinicalpharmacy.org/wp-content/uploads/2023/06/Drug-dosing-extreme-body-weight-2013-1Ed.pdf.