- First generation cephalosporin for treatment of infection caused by susceptible bacteria
|
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
- 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
(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 - 20 mg/mL for dose less than 200 mg |
| IV Intermittent Infusion |
YES - 20 mg/mL for dose less than 200 mg |
| IV Continuous Infusion | NO |
(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)
- Prophylaxis, Cardiac surgery: 40 mg/kg/dose IV Q 8 hours (Max 2 g/dose)
- 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)
- Prophylaxis, Cardiac surgery: 40 mg/kg/dose IV Q 8 hours (Max 2 g/dose)
DOSING ADJUSTMENT IN RENAL IMPAIRMENT:
- CrCl 10-30 mL/min: Administer Q 12 hours
- CrCl < 10 mL/min: Administer Q 24 hours
- 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
- 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