Parenteral Manual

CeFAZolin

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
ANCEF®, KEFZOL®
Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
June 2020
Indications: 
  • First generation cephalosporin for treatment of infection caused by susceptible bacteria
Reconstitution and Stability: 

VIAL SIZE

STERILE WATER for INJECTION REQUIRED

FINAL CONCENTRATION

500 mg

4.8 mL

100 mg/mL

1000 mg

9.5 mL

100 mg/mL

10,000 mg

96 mL

100 mg/mL

  • Store powder at room temperature. Protect powder and solution from light
  • Reconstituted vial stable 24 hours at room temperature, 72 hours refrigerated for bulk pharmacy vials
  • Diluted solutions stable 24 hours at room temperature or refrigerated

FOR IM USE:

  • Reconstitute 1 g vial with 3 mL sterile water for injection to get a final concentration of 334 mg/mL
Compatibility: 

- Solutions Compatible:  D5W, 0.9 % NaCl, dextrose-saline combinations, ringer's solution, ringer's lactate

- Additive/Above Cassette Compatible: metronidazole

- Y-site Compatible: morphine, TPN (amino acids/dextrose), hydromorphone, potassium chloride

- Incompatible: aminoglycoside antibiotics; administration of beta lactam and aminoglycoside antibiotics should be separated

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES, deeply into a large muscle at same doses as those given IV
IV Direct

YES
Usual dilution: 100 mg/mL

-  20 mg/mL for dose less than 200 mg
Infusion time: 3-5 minutes

IV Intermittent Infusion

YES
Usual dilution: 100 mg/mL

- 20 mg/mL for dose less than 200 mg
Infusion time: 10-60 minutes

IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

PEDIATRIC:            

  • Mild to moderate infections: 100 mg/kg/day IV/IM ÷ Q 6 - 8 hours (Maximum: 8 g/day)
  • Osteoarticular infections or other serious infections: 100 - 150 mg/kg/day IV/IM ÷ Q 6 hours (Maximum: 12 g/day)
  • Refer to  CHEO guidelines for - Antimicrobials for Surgical Prophylaxis (on Spectrum)
                                            

ADOLESCENT/ADULT:  

  • Usual adult dose: 0.5 - 2 g IV/IM Q 6-8 hours (Maximum dose: 8 g/day)
  • Toxic Shock and Necrotizing Fasciitis:  2 g IV Q6H (8 g/day)

DOSING ADJUSTMENT IN RENAL IMPAIRMENT:

  • CrCl 10-30 mL/min: Administer Q 12 hours
  • CrCl < 10 mL/min: Administer Q 24 hours
Potential hazards of parenteral administration: 
  • Hypersensitivity reactions
  • Thrombophlebitis with IV administration                                                         
  • Pain on IM injection
  • Elevations of hepatic enzymes, BUN, and/or serum creatinine
  • Increased possibility of renal toxicity when used concurrently with aminoglycosides
Notes: 
  • Monitor renal function, CBC and hepatic function
  • Allergic reactions - possible cross sensitivity with penicillins (approximately 8-12%)
  • Can cause false positive Coombs test
  • Produces false positive urine glucose with Clinitest
  • Sodium content is 46 mg (2 mmol) per gram of cefazolin

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.