Drug Information for CEFAZOLIN FOR INJECTION USP (Hospira, Inc.): DOSAGE AND ADMINISTRATION

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  • Usual Adult Dosage
    Type of Infection Dose Frequency
    Moderate to severe infections 500 mg to 1 gram every 6 to 8 hrs.
    Mild infections caused by susceptible gram–positive cocci 250 mg to 500 mg every 8 hours
    Acute, uncomplicated urinary tract infections 1 gram every 12 hours
    Pneumococcal pneumonia 500 mg every 12 hours
    Severe, life-threatening infections (e.g., endocarditis, septicemia) ln rare instances, doses of up to 12 grams of cefazolin for injection per day have been used 1 gram to 1.5 grams every 6 hours
  • Perioperative Prophylactic Use

  • To prevent postoperative infection in contaminated or potentially contaminated surgery, recommended doses are:

    a. 1 gram IV or IM administered 1/2 hour to 1 hour prior to the start of surgery.

    b. For lengthy operative procedures (e.g., 2 hours or more), 500 mg to 1 gram IV or IM during surgery (administration modified depending on the duration of the operative procedure).

    c. 500 mg to 1 gram IV or IM every 6 to 8 hours for 24 hours postoperatively.

    It is important that (1) the preoperative dose be given just (1/2 to 1 hour) prior to the start of surgery so that adequate antibiotic levels are present in the serum and tissues at the time of initial surgical incision; and (2) Cefazolin be administered, if necessary, at appropriate intervals during surgery to provide sufficient levels of the antibiotic at the anticipated moments of greatest exposure to infective organisms.

    In surgery where the occurrence of infection may be particularly devastating (e.g., open-heart surgery and prosthetic arthroplasty), the prophylactic administration of cefazolin for injection may be continued for 3 to 5 days following the completion of surgery.

  • Dosage Adjustment for Patients with Reduced Renal Function

  • Cefazolin may be used in patients with reduced renal function with the following dosage adjustments: Patients with a creatinine clearance of 55 mL/min. or greater or a serum creatinine of 1.5 mg % or less can be given full doses. Patients with creatinine clearance rates of 35 to 54 mL/min. or serum creatinine of 1.6 to 3 mg % can also be given full doses but dosage should be restricted to at least 8 hour intervals. Patients with creatinine clearance rates of 11 to 34 mL/min. or serum creatinine of 3.1 to 4.5 mg % should be given 1/2 the usual dose every 12 hours. Patients with creatinine clearance rates of 10 mL/min. or less or serum creatinine of 4.6 mg % or greater should be given 1/2 the usual dose every 18 to 24 hours. All reduced dosage recommendations apply after an initial loading dose appropriate to the severity of the infection. Patients undergoing peritoneal dialysis: See CLINICAL PHARMACOLOGY.

  • Pediatric Dosage

  • In pediatric patients, a total daily dosage of 25 to 50 mg per kg (approximately 10 to 20 mg per pound) of body weight, divided into 3 or 4 equal doses, is effective for most mild to moderately severe infections. Total daily dosage may be increased to 100 mg per kg (45 mg per pound) of body weight for severe infections. Since safety for use in premature infants and in neonates has not been established, the use of Cefazolin for injection in these patients is not recommended.

    Pediatric Dosage Guide
    Weight 25 mg/kg/DayDivided into 3 Doses 25 mg/kg/DayDivided into 4 Doses
    Lbs Kg ApproximateSingle Dosemg/q8hVol. (mL) needed withdilution of125 mg/mLApproximateSingle Dosemg/q6h Vol. (mL) needed withdilution of125 mg/mL
    104.540 mg0.35 mL30 mg0.25 mL
    20975 mg0.6 mL55 mg0.45 mL
    3013.6115 mg0.9 mL85 mg0.7 mL
    4018.1150 mg1.2 mL115 mg0.9 mL
    5022.7190 mg1.5 mL140 mg1.1 mL
    Weight50 mg/kg/DayDivided into 3 Doses50 mg/kg/DayDivided into 4 Doses
    LbsKgApproximateSingle Dosemg/q8h Vol. (mL) needed withdilution of225 mg/mL ApproximateSingle Dosemg/q6h Vol. (mL) needed withdilution of225 mg/mL
    104.575 mg0.35 mL55 mg0.25 mL
    209150 mg0.7 mL110 mg0.5 mL
    3013.6225 mg1 mL170 mg0.75 mL
    4018.1300 mg1.35 mL225 mg1 mL
    5022.7375 mg1.7 mL285 mg1.25 mL

    In pediatric patients with mild to moderate renal impairment (creatinine clearance of 70 to 40 mL/min.), 60 percent of the normal daily dose given in equally divided doses every 12 hours should be sufficient. In patients with moderate impairment (creatinine clearance of 40 to 20 mL/min.), 25 percent of the normal daily dose given in equally divided doses every 12 hours should be adequate. Pediatric patients with severe renal impairment (creatinine clearance of 20 to 5 mL/min.) may be given 10 percent of the normal daily dose every 24 hours. All dosage recommendations apply after an initial loading dose.

  • Preparation of Parenteral Solution

  • Parenteral drug products should be SHAKEN WELL when reconstituted, and inspected visually for particulate matter prior to administration. If particulate matter is evident in reconstituted fluids, the drug solutions should be discarded.

    When reconstituted or diluted according to the instructions below, cefazolin for injection is stable for 24 hours at room temperature or for 10 days if stored under refrigeration (5°C or 41 °F). Reconstituted solutions may range in color from pale yellow to yellow without a change in potency.

  • Single-Dose Vials

  • For IM injection, IV direct (bolus) injection or IV infusion, reconstitute with Sterile Water for Injection according to the following table. SHAKE WELL.

    Vial sizeAmount of DiluentApproximate ConcentrationApproximate Available Volume
    1 gram2.5 mL330 mg/mL3 mL
  • Intramuscular Administration

  • Reconstitute vials with Sterile Water for Injection according to the dilution table above. Shake well until dissolved. Cefazolin should be injected into a large muscle mass. Pain on injection is infrequent with cefazolin.

  • Intravenous Administration

  • Direct (bolus) injection: Following reconstitution according to the above table, further dilute vials with approximately 5 mL Sterile Water for Injection. Inject the solution slowly over 3 to 5 minutes, directly or through tubing for patients receiving parenteral fluids (see list below).

    Intermittent or continuous infusion: Dilute reconstituted cefazolin in 50 to 100 mL of 1 of the following solutions:

    Sodium Chloride Injection, USP

    5% or 10% Dextrose Injection, USP

    5% Dextrose in Lactated Ringer's Injection, USP

    5% Dextrose and 0.9% Sodium Chloride Injection, USP

    5% Dextrose and 0.45% Sodium Chloride Injection, USP

    5% Dextrose and 0.2% Sodium Chloride Injection, USP

    Lactated Ringer's Injection, USP

    Invert Sugar 5% or 10% in Sterile Water for Injection

    Ringer's Injection, USP

    5% Sodium Bicarbonate Injection, USP

  • Drug Information Provided by National Library of Medicine (NLM).
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