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Cefazolin

Surgical site infection prophylaxis (first-line), Skin and soft tissue infections, Cellulitis

Indications

  • Surgical site infection prophylaxis (first-line)
  • Skin and soft tissue infections
  • Cellulitis

Adult dosing

  • surgical prophylaxis: dose: 2; unit: g; route: IV; interval: Within 60 min before incision; re-dose q4h if surgery >4h or EBL >1500mL; fixed: true; surgical prophylaxis large: dose: 3; unit: g; route: IV; interval: For patients ≥120kg; fixed: true

Contraindications

  • Anaphylaxis to cephalosporins (cross-reactivity with penicillin ~1%)

Clinical pearls

  • First-line surgical prophylaxis for most clean and clean-contaminated surgeries
  • Must be given within 60 min of incision — every minute delay increases SSI risk
  • Re-dose intraoperatively if case >4h or significant blood loss (>1500mL)
  • 3g dose for patients ≥120kg

Source and review

  • ASHP/IDSA/SHEA/SIS Surgical Prophylaxis Guidelines 2013. Last reviewed: 2024-11-01