Cefazolin in Dextrose (Premixed)

Osmolarity: ≈ 300 mOsm/LTonicity: Approximately isotonicpH: 4.5 – 7.0

Clinical Indications

Surgical prophylaxis (MOST COMMON USE — 1–2 g within 60 min before incision), skin and soft tissue infections, bacteraemia, endocarditis prophylaxis, UTIs, and respiratory tract infections caused by susceptible organisms (S. aureus, E. coli, Klebsiella, Proteus mirabilis).

Dosing & Administration Rate

Surgical prophylaxis: 1–2 g IV 30–60 min pre-incision; re-dose every 4 hrs in long operations or with major blood loss. Moderate infections: 500 mg–1 g IV q8h. Severe infections: 1–2 g IV q6–8h. Adjust for CrCl <35 mL/min.

Warnings & Precautions

Cross-reactivity with penicillins (≈1–2%). Screen for beta-lactam allergy. Monitor renal function. May cause Clostridioides difficile colitis. Not for CNS infections (poor CSF penetration). First-generation cephalosporin — limited Gram-negative coverage.

Contraindications

History of severe hypersensitivity (e.g., anaphylaxis) to penicillins or cephalosporins.

Pharmacology & Safety Profile

Mechanism of Action

First-generation cephalosporin. Binds to penicillin-binding proteins (PBPs), inhibiting bacterial cell wall synthesis and causing cell lysis.

Adverse Reactions

Diarrhea, nausea, rash, injection site phlebitis, drug-induced eosinophilia, elevated transaminases, C. difficile infection.

Compatibility Notes

Incompatible with aminoglycosides in same line (gentamicin, tobramycin). Compatible with D5W, NS, LR. Stable 48 hrs at room temperature after reconstitution.

Electrolyte & Composition Profile

Component	Amount / Concentration
Cefazolin Sodium	1 g or 2 g per bag (20 mg/mL or 40 mg/mL typical)
Dextrose (Anhydrous)	50 mg/mL (5%)
Water for Injection	q.s.
Caloric Density	170 kcal/L (from dextrose)

Clinical Parameters

RouteIntravenous (intermittent infusion)

Fluid CategoryCrystalloid Solution

Required MonitoringVital signs, fluid intake/output, baseline electrolytes

Administration SetupPeripheral or central venous access. Infuse over 30 minutes.

Pregnancy SafetyCategory B (FDA). Widely considered safe and commonly used for surgical prophylaxis (e.g., C-section) during pregnancy.

StoragePremixed bags: store frozen at −20°C. Thaw at room temperature. Stable 48 hrs refrigerated after thawing.

Prescription Status Rx Only

Clinical Disclaimer: Data compiled from FDA DailyMed, Baxter/Fresenius prescribing information, and USP monographs. Always verify against the physical product label, your institution's IV protocols, and current pharmacist guidance before administration.

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