Cefazolin

1st Gen Cephalosporin·Infectious Diseases - Cephalosporins

Surgical prophylaxis, severe skin and soft tissue infections, MSSA endocarditis

CEPHALOSPORINKefzolVials (1 g, 2 g powder) for…S4TGA

Max Dose

6 g/day

Half-life

2 h

Cross-Allergy

LOW RISK

Renal Adj.

DOSE RED.

Rapid Summary

Overview

First-generation IV cephalosporin. Outstanding coverage against MSSA and Streptococci. The absolute gold-standard worldwide for surgical site prophylaxis.

Maximum Dose

Max 6 g/day (e.g., 2 g TDS).

Clinical Focus

Highly renally cleared. Failure to adjust the dose in severe kidney disease will cause neurotoxicity.

Bottom Line

Cefazolin is the first-line IV surgical prophylaxis cephalosporin with excellent staphylococcal coverage, but has limited gram-negative spectrum and ~2% cross-reactivity in penicillin-allergic patients.

Formulation & Access

Brand Names

Kefzol

Parenteral

Vials (1 g, 2 g powder) for IV injection/infusion.

Prescribing & PBS

Hospital supply.

Indications & Use

Primary

TGA

Surgical prophylaxis, severe skin and soft tissue infections, MSSA endocarditis.

Clinical Place

Often replaces IV Flucloxacillin in patients who cannot tolerate Flucloxacillin's severe phlebitis or frequent dosing schedule.

Quick reference

Class & Role

1st Gen Cephalosporin — First-generation IV cephalosporin.

Route / Formulation

Vials (1 g, 2 g powder) for IV injection/infusion. (Kefzol)

Usual Dose & Max

IV 2 g STAT within 60 mins prior to surgical incision. (Add a further 1 g intra-op if surgery lasts > 4 hours). Max 6 g/day (e.g., 2 g TDS).

Key Indication Doses

Surgical Prophylaxis: IV 2 g STAT within 60 mins prior to surgical incision. (Add a further 1 g intra-op if surgery lasts > 4 hours). Severe Cellulitis / MSSA Bacteremia: IV 2 g q8h. Renal Impairment: Reduce frequency. If eGFR 10-30, give q12h. If eGFR < 10, give 1g q24h.

Best Uses

Avoid / Cautions

Previous cephalosporin anaphylaxis. Pregnancy Category B1. The drug of choice for Caesarean section prophylaxis.

Key Risks

Immunological: Hypersensitivity. (Cross-reactivity with true penicillin allergy is < 2%, but avoid if the patient had recent anaphylaxis). Gastrointestinal: Nausea, C. difficile infection. Neurological: Seizures/encephalopathy (if massive doses accumulate in renal failure).

Key Interactions

Exceptionally clean drug interaction profile. Highly safe to use with anaesthetic agents.

Monitoring

Check eGFR to ensure appropriate maintenance dosing frequency. For surgical prophylaxis, the drug MUST be completely infused *before* the surgeon cuts the skin, otherwise the wound is unprotected.

Clinical Pearl

For surgical prophylaxis in bariatric patients (> 120 kg), a standard 2 g dose does not provide adequate tissue concentrations. The dose MUST be increased to 3 g IV.

Access

Kefzol

Brand: Kefzol

Cefazolin

1st Gen Cephalosporin·Infectious Diseases - Cephalosporins

Surgical prophylaxis, severe skin and soft tissue infections, MSSA endocarditis

CEPHALOSPORINKefzolVials (1 g, 2 g powder) for…S4TGA

Max Dose

6 g/day

Half-life

2 h

Cross-Allergy

LOW RISK

Renal Adj.

DOSE RED.

Rapid Summary

Overview

First-generation IV cephalosporin. Outstanding coverage against MSSA and Streptococci. The absolute gold-standard worldwide for surgical site prophylaxis.

Maximum Dose

Max 6 g/day (e.g., 2 g TDS).

Clinical Focus

Highly renally cleared. Failure to adjust the dose in severe kidney disease will cause neurotoxicity.

Bottom Line

Formulation & Access

Brand Names

Kefzol

Parenteral

Vials (1 g, 2 g powder) for IV injection/infusion.

Prescribing & PBS

Hospital supply.

Indications & Use

Primary

TGA

Surgical prophylaxis, severe skin and soft tissue infections, MSSA endocarditis.

Clinical Place

Often replaces IV Flucloxacillin in patients who cannot tolerate Flucloxacillin's severe phlebitis or frequent dosing schedule.

Quick reference

Class & Role

1st Gen Cephalosporin — First-generation IV cephalosporin.

Route / Formulation

Vials (1 g, 2 g powder) for IV injection/infusion. (Kefzol)

Usual Dose & Max

IV 2 g STAT within 60 mins prior to surgical incision. (Add a further 1 g intra-op if surgery lasts > 4 hours). Max 6 g/day (e.g., 2 g TDS).

Key Indication Doses

Best Uses

Avoid / Cautions

Previous cephalosporin anaphylaxis. Pregnancy Category B1. The drug of choice for Caesarean section prophylaxis.

Key Risks

Key Interactions

Exceptionally clean drug interaction profile. Highly safe to use with anaesthetic agents.

Monitoring

Check eGFR to ensure appropriate maintenance dosing frequency. For surgical prophylaxis, the drug MUST be completely infused *before* the surgeon cuts the skin, otherwise the wound is unprotected.

Clinical Pearl

For surgical prophylaxis in bariatric patients (> 120 kg), a standard 2 g dose does not provide adequate tissue concentrations. The dose MUST be increased to 3 g IV.

Access

Kefzol

Brand: Kefzol