:Cefazolin

Cefazolin is used in a variety of infections provided that susceptible organisms are involved. It is indicated for use in the following infections:{{Cite web|title = DailyMed - CEFAZOLIN - cefazolin sodium injection, powder, for solution|url = http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=79afc719-8279-49f9-83b0-e0736c07eb5c|website = dailymed.nlm.nih.gov|access-date = 2015-11-05|url-status = live|archive-url = https://web.archive.org/web/20160306013731/http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=79afc719-8279-49f9-83b0-e0736c07eb5c|archive-date = 2016-03-06}}

• Respiratory tract infections
• Urinary tract infections
• Skin infections
• Biliary tract infections
• Bone and joint infections
• Genital infections
• Blood infections (sepsis)
• Endocarditis

It can also be used peri-operatively to prevent infections post-surgery, and is often the preferred drug for surgical prophylaxis.

There is no penetration into the central nervous system and therefore cefazolin is not effective in treating meningitis.{{cite book | vauthors = Trevor AJ, Katzung BG, Masters S |title = Basic & Clinical Pharmacology |publisher = McGraw Hill Education|year = 2015|isbn = 978-0-07-182505-4|location = New York|pages = 776–778}}

Cefazolin has been shown to be effective in treating methicillin-susceptible Staphylococcus aureus (MSSA) but does not work in cases of methicillin-resistant Staphylococcus aureus (MRSA). In many instances of staphylococcal infections, such as bacteremia, cefazolin is an alternative to penicillin in patients who are allergic to penicillin. However, there is still potential for a reaction to occur with cefazolin and other cephalosporins in patients allergic to penicillin. Resistance to cefazolin is seen in several species of bacteria, such as Mycoplasma and Chlamydia, in which case different generations of cephalosporins may be more effective.{{cite web|title = Cefazolin (Injection Route)|publisher = Mayo Clinic|date = 1 July 2015|url = http://www.mayoclinic.org/drugs-supplements/cefazolin-injection-route/before-using/drg-20073267|url-status = live|archive-url = https://web.archive.org/web/20140419012252/http://www.mayoclinic.org/drugs-supplements/cefazolin-injection-route/before-using/drg-20073267|archive-date = 19 April 2014}} Cefazolin does not fight against Enterococcus, anaerobic bacteria, or atypical bacteria, among others.

As a first-generation cephalosporin antibiotic, cefazolin and other first-generation antibiotics are very active against gram-positive bacteria and some gram-negative bacteria. Their broad spectrum of activity can be attributed to their improved stability to many bacterial beta-lactamases compared to penicillins.

Gram-positive aerobes:

• Staphylococcus aureus (including beta-lactamase producing strains)
• Staphylococcus epidermidis
• Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus pneumoniae and other strains of streptococci

Gram-Negative Aerobes:{{Cite book | vauthors = Beauduy C, Winston L |publisher=McGraw Hill|url=https://accesspharmacy.mhmedical.com/content.aspx?bookid=2988§ionid=250601638 |title=Basic & Clinical Pharmacology |year=2021 |edition=15}}

• Escherichia coli
• Proteus mirabilis
• Klebsiella pneumoniae

The following are not susceptible:

• Methicillin-resistant staphylococcus aureus
• Enterococcus
• most strains of indole positive Proteus (Proteus vulgaris)
• Enterobacter spp.
• Morganella morganii
• Providencia rettgeri
• Serratia spp.
• Pseudomonas spp.
• Listeria

Cefazolin is pregnancy category B, indicating general safety for use in pregnancy. Caution should be used in breastfeeding as a small amount of cefazolin enters the breast milk. Cefazolin can be used prophylactically against perinatal Group B streptococcal infection (GBS). Although penicillin and ampicillin are the standard of care for GBS prophylaxis, penicillin-allergic women with no history of anaphylaxis can be given cefazolin instead. These patients should be closely monitored as there is a small chance of an allergic reaction due to the similar structure of the antibiotics.{{Cite web|title = Prevention of Perinatal Group B Streptococcal Disease|url = https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm|website = www.cdc.gov|access-date = 2015-11-05|url-status = live|archive-url = https://web.archive.org/web/20151115063145/http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm|archive-date = 2015-11-15}}

There has been no established safety and effectiveness for use in premature infants and neonates.

No overall differences in safety or effectiveness were observed in clinical trials comparing elderly and younger subjects, however the trials could not eliminate the possibility that some older individuals may have a higher level of sensitivity.

People with kidney disease and those on hemodialysis may need the dose adjusted. Cefazolin levels are not significantly affected by liver disease.

As with other antibiotics, cefazolin may interact with other medications being taken. Some important drugs that may interact with cefazolin such as probenecid.

Side effects associated with use of cefazolin therapy include:

• Common (1–10%): diarrhea, stomach pain or upset stomach, vomiting, and rash.
• Uncommon (<1%): dizziness, headache, fatigue, itching, transient hepatitis.{{Cite web|url =http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/50461slr139_ancef_lbl.pdf|title =Cefazolin Prescribing Information|date =2004|publisher =FDA|url-status =live|archive-url =https://web.archive.org/web/20160304070705/http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/50461slr139_ancef_lbl.pdf|archive-date =2016-03-04}}

Patients with penicillin allergies could experience a potential reaction to cefazolin and other cephalosporins. As with other antibiotics, patients experiencing watery and/or bloody stools occurring up to three months following therapy should contact their prescriber.

Like those of several other cephalosporins, the chemical structure of cefazolin contains an N-methylthiodiazole (NMTD or 1-MTD) side-chain. As the antibiotic is broken down in the body, it releases free NMTD, which can cause hypoprothrombinemia (likely due to inhibition of the enzyme vitamin K epoxide reductase) and a reaction with ethanol similar to that produced by disulfiram (Antabuse), due to inhibition of aldehyde dehydrogenase.{{Cite book|title = Antibiotics, antifungals, and antivirals| vauthors = Stork CM|publisher =McGraw-Hill|year = 2006|location = New York|pages = 847}} Those with an allergy to penicillin may develop a cross sensitivity to cefazolin.{{cite web |publisher =Vancouver Acute Pharmaceutical Sciences, Vancouver Hospital & Health Sciences Centre |date =2016 |access-date =May 19, 2017 |url =http://www.vhpharmsci.com/vhformulary/Tools/ANTIBIOTIC%20CROSS-SENSITIVITY%20CHART.pdf |title =Pharmaceutical Sciences CSU Parenteral Antibiotic Allergy cross-sensitivity chart |url-status =live |archive-url =https://web.archive.org/web/20160417213010/http://www.vhpharmsci.com/VHFormulary/Tools/ANTIBIOTIC%20CROSS-SENSITIVITY%20CHART.pdf |archive-date =April 17, 2016 }}{{cite journal | vauthors = Gonzalez-Estrada A, Radojicic C | title = Penicillin allergy: A practical guide for clinicians | journal = Cleveland Clinic Journal of Medicine | volume = 82 | issue = 5 | pages = 295–300 | date = May 2015 | pmid = 25973877 | doi = 10.3949/ccjm.82a.14111 | s2cid = 6717270 | doi-access = free }}

Cefazolin inhibits cell wall biosynthesis by binding penicillin-binding proteins which stops peptidoglycan synthesis. Penicillin-binding proteins are bacterial proteins that help to catalyze the last stages of peptidoglycan synthesis, which is needed to maintain the cell wall. They remove the D-alanine from the precursor of the peptidoglycan. The lack of synthesis causes the bacteria to lyse because they also continually break down their cell walls. Cefazolin is bactericidal, meaning it kills the bacteria rather than inhibiting their growth.

Cefazolin is relatively inexpensive.{{cite book | vauthors = Cunha BA |title=Infectious Diseases in Critical Care Medicine |date=2009 |publisher=CRC Press |isbn=978-1-4200-9241-7 |page=506 |url=https://books.google.com/books?id=syasCQAAQBAJ&pg=PA506 |language=en}}

It was initially marketed by GlaxoSmithKline under the trade name Nostof.{{Cite web|title = Cefazolin Sodium Injection | work = MedlinePlus Drug Information| publisher = U.S. National Library of Medicine | url = https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682731.html |access-date = 2015-11-05|url-status = live|archive-url = https://web.archive.org/web/20151006090658/https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682731.html|archive-date = 2015-10-06}}

Other trade names include: Cefacidal, Cefamezin, Cefrina, Elzogram, Faxilen, Gramaxin, Kefol, Kefzol, Kefzolan, Kezolin, Novaporin, Reflin, Zinol, and Zolicef.

{{Reflist}}

• [https://medlineplus.gov/druginfo/meds/a682731.html MedlinePlus Drug Information: Cefazolin Sodium Injection.]

{{CephalosporinAntiBiotics}}

{{portal bar|Medicine}}

Category:Cephalosporin antibiotics

Category:World Health Organization essential medicines

Category:Tetrazoles

Category:Thiadiazoles

Category:Wikipedia medicine articles ready to translate