Disclaimer to the On-line Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.



  • cefazolin is a "first generation" semisynthetic cephalosporin antibiotic which has activity against Gram-positive bacteria and some Gram-negative bacteria


  • the antibacterial activity of cefazolin, like the penicillins, results from the inhibition of bacterial cell wall synthesis
  • cefazolin is eliminated unchanged in the urine
  • first generation cephalosporins are usually active in vitro against Gram-positive cocci (S. aureus, S. epidermidis, Streptococcus pyogenes, group B Streptococci and Streptococcus pneumoniae);
  • first generation cephalosporins have limited activity against Gram-negative organisms

The Following Organisms are Resistant

  • enterococci, methicillin-resistant staphylococci, Bacteroides fragilis, Enterobacter, Listeria monocytogenes, Pseudomonas, Providencia and Serratia
  • cefazolin does NOT penetrate into the CNS

Side Effects

  • hypersensitivity reactions (eg. fever, rash, urticaria)
  • positive direct and indirect Coombs' test results have been reported
  • transient elevation of liver enzymes
  • rare hematologic effects which have been reported include mild and transient neutropenia and thrombocytopenia


< 2,000 g 20 mg/kg q12h
> 2,000 g< 7 days20 mg/kg q12h
 > 7 days20 mg/kg q8h
  • give by slow IV infusion


  • 20 mg/mL syringe prepared by Pharmacy
  • available in a 1g vial - add 4.5mL sterile water for injection to make a solution of 200 mg/mL. Add 1 mL of this solution to 9 mL sterile water for injection. This will produce a final concentration of 200 mg/10 mL (20mg/mL) which may be added to a running IV and given by slow infusion.


  1. McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
  2. Bhatt DR, Furman GI, Reber DJ et al: Neonatal Drug Formulary, 1990-1991, 2nd Edition, Fontana, California 92334.
  3. Taketomo CK, Hodding JH and Kraus DM: Pediatric Dosage Handbook, Lexi-Comp Inc., Cleveland, 1992.
  4. Ford DC, Leist ER and Phelps SJ: Guidelines for administration of intravenous medications to pediatric patients, American Society of Hospital Pharmacists, Bethesda, MD, 1988.
  5. Yaffe SJ and Aranda JV (Eds): Pediatric Pharmacology-Therapeutic Principles in Practice, WB Saunders Co, Toronto, Ontario 2nd Edition, 1992.
  6. "Ancef(R)", package insert, Smith Kline Beachan Inc, Oakville, Ontario.

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