ANCEF IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Cefazolin is a first-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.
| Metabolism | Cefazolin is not significantly metabolized; it is primarily excreted unchanged in the urine via renal tubular secretion and glomerular filtration. |
| Excretion | Renal (80-90% unchanged via glomerular filtration and tubular secretion); biliary (minimal, <1%); fecal (<1%) |
| Half-life | 1.8 hours (normal renal function); prolonged to 10-12 hours in ESRD; clinical context: dosing interval adjustment required for CrCl <55 mL/min |
| Protein binding | 80-86% bound to albumin |
| Volume of Distribution | 0.12-0.14 L/kg; clinical meaning: low Vd indicates limited extravascular distribution, primarily confined to extracellular fluid |
| Bioavailability | IM: nearly 100% |
| Onset of Action | IV: immediate; IM: within 30 minutes |
| Duration of Action | 6-8 hours (normal renal function); extended in renal impairment; clinical notes: sustained bactericidal levels for susceptible organisms |
| Molecular Weight | 454.51 |
1-2 g IV every 8 hours for moderate to severe infections; 2 g IV every 6-8 hours for life-threatening infections.
| Dosage form | INJECTABLE |
| Renal impairment | CrCl 30-60 mL/min: 1-2 g every 12 hours; CrCl 10-29 mL/min: 1-2 g every 24 hours; CrCl <10 mL/min: 1-2 g every 48 hours. |
| Liver impairment | No dose adjustment required for hepatic impairment; dose based on renal function. |
| Pediatric use | 50-100 mg/kg/day IV divided every 8 hours; for severe infections up to 100 mg/kg/day divided every 6-8 hours; maximum 6 g/day. |
| Geriatric use | Initial dosing based on renal function; monitor CrCl and adjust per renal guidelines; age-related decline in renal function necessitates careful dose calculation. |
| 1st trimester | Crosses placenta. No evidence of risk in human studies; use if clearly needed. |
| 2nd trimester | Crosses placenta. Considered safe; use if clearly needed. |
| 3rd trimester | Crosses placenta. Considered safe; use if clearly needed. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Cefazolin readily crosses the placenta. Peak cord blood concentrations are approximately 50% of maternal serum concentrations. |
| Breastfeeding | Cefazolin is excreted into breast milk in small amounts. Concentrations are low and unlikely to cause adverse effects in the nursing infant. Compatible with breastfeeding; use with caution in infants with hypersensitivity to cephalosporins. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Cefazolin is pregnancy category B. No evidence of teratogenicity in animal studies; however, adequate human studies are lacking. Use in first trimester generally avoided unless clearly needed. No known fetal risks in second and third trimesters. |
| Fetal Monitoring | Monitor for allergic reactions, anaphylaxis. Renal function monitoring advised with prolonged use. No specific fetal monitoring required, but consider fetal exposure when used during labor. |
| Fertility Effects | No known adverse effects on fertility in animal studies. Human data limited, but not expected to impair reproductive function. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
Hypersensitivity to cefazolin or any cephalosporinSevere immediate hypersensitivity reaction to penicillins (cross-hypersensitivity)
| Precautions | Hypersensitivity reactions including anaphylaxis, Clostridium difficile-associated diarrhea, Renal impairment requiring dose adjustment, Coagulation abnormalities (prolonged prothrombin time), Superinfection with resistant organisms |
| Food/Dietary | No significant food interactions. No dietary restrictions required. May be administered without regard to meals. |
| Clinical Pearls | First-generation cephalosporin; ensure renal dose adjustment in CrCl < 55 mL/min; use for surgical prophylaxis within 60 minutes prior to incision; no cross-allergy absolute with penicillins (approx 5-10% risk); monitor for Clostridioides difficile diarrhea. |
| Patient Advice | This medication is an antibiotic given intravenously (IV) to treat or prevent bacterial infections. · Inform your healthcare provider if you have any allergies, especially to penicillins or cephalosporins. · Report any signs of allergic reaction: rash, itching, swelling, difficulty breathing. · Take the full course of therapy as prescribed; do not stop early even if you feel better. · Notify your doctor if you develop severe diarrhea, especially if watery or bloody. · This product contains sodium; consult your doctor if you are on a sodium-restricted diet. |
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