Cefazolin

 Risk Factor: BM
 Class: ANTI-INFECTIVES / Cephalosporins

Contents of this page:

Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers

Fetal Risk Summary

Cefazolin is a parenteral, semisynthetic cephalosporin antibiotic. Reproduction studies in mice, rats, and rabbits found no evidence of impaired fertility or fetal harm at doses up to 25 times the human dose (1).

Cefazolin crosses the placenta into the cord serum and amniotic fluid (2,3,4,5 and 6). In early pregnancy, distribution is limited to the body fluids and these concentrations are considerably lower than those found in the 2nd and 3rd trimesters (3). At term, 1570 minutes after a 500-mg dose, cord serum levels range from 35 to 69% of maternal serum (4). The maximum concentration in amniotic fluid after 500 mg was 8 g/mL at 2.5 hours (5). No data on the newborns were given. Following a 2-g IV dose to seven women between 23 and 32 weeks' gestation, the mean serum concentration of cefazolin in hydropic and nonhydropic fetuses was 18.04 and 21.02 g/mL, respectively, providing evidence that the presence of hydrops did not significantly impair the transfer of the antibiotic (6).

Cephalosporins are usually considered safe to use during pregnancy. Cefazolin, 2 g IV every 8 hours, has been used in the treatment of pyelonephritis occurring in the second half of pregnancy (7). No adverse fetal outcomes attributable to the drug were observed.

Breast Feeding Summary

Cefazolin is excreted into breast milk in low concentrations. Following a 2-g IV dose, average milk levels ranged from 1.2 to 1.5 g/mL over 4 hours (milk:plasma ratio 0.02) (8). When cefazolin was given as a 500-mg IM dose, one to three times daily, the drug was not detectable (5). Although these levels are low, three potential problems exist for the nursing infant: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. The American Academy of Pediatrics considers cefazolin to be compatible with breast feeding (9).

References

1. Product information. Ancef. SmithKline Beecham Pharmaceuticals, 1997.
2. Dekel A, Elian I, Gibor Y, Goldman JA. Transplacental passage of cefazolin in the first trimester of pregnancy. Eur J Obstet Gynecol Reprod Biol 1980;10:3037.
3. Bernard B, Barton L, Abate M, Ballard CA. Maternal-fetal transfer of cefazolin in the first twenty weeks of pregnancy. J Infect Dis 1977;136:37782.
4. Cho N, Ito T, Saito T, et al. Clinical studies on cefazolin in the field of obstetrics and gynecology. Chemotherapy (Tokyo) 1970;18:7707.
5. von Kobyletzki D, Reither K, Gellen J, Kanyo A, Glocke M. Pharmacokinetic studies with cefazolin in obstetrics and gynecology. Infection 1974;2(Suppl):607.
6. Brown CEL, Christmas JT, Bawdon RE. Placental transfer of cefazolin and piperacillin in pregnancies remote from term complicated by Rh isoimmunization. Am J Obstet Gynecol 1990;163:93843.
7. Sanchez-Ramos L, McAlpine KJ, Adair CD, Kaunitz AM, Delke I, Briones DK. Pyelonephritis in pregnancy: once-a-day ceftriaxone versus multiple doses of cefazolin. Am J Obstet Gynecol 1995;172:12933.
8. Yoshioka H, Cho K, Takimato M, Maruyama S, Shimizu T. Transfer of cefazolin into human milk. J Pediatr 1979;94:1512.
9. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
   
   

Questions and Answers

How does Cefazolin work?,

Cefazolin is a cephalosporin, a cousin of penicillin. It works by inhibiting bacterial cell wall synthesis causing the bacteria to break open and die as they grow.

Cefazolin sodium in aqueous solution/physical changes?, Cefazolin sodium is an antibiotic formulated as an intramuscular injection. Solid cefazolin sodium crystals are dissolved in an aqueous solution, to bring the formulation to its appropriate potency.
You have been asked to compound this solution, and find an old bottle of cefazolin sodium crystals in the back of the stock room.
Despite following the formulary instructions for preparation of the solution, you find that it is impossible to dissolve the recommended amount of solid in aqueous solution.

Describe what physical changes could have occurred that would be consistent with a loss in solubility of crystalline cefazolin sodium. Describe why this/these changes result in a loss of aqueous solubility.

Cefazolin sodium is a first generation cephalosporin. The multi-ring structure is very complex. The chemical name is Sodium salt of 3- [(5-methyl -1,3,4- thiadiazol -2- yl) sulfanylmethyl]-
8-oxo-7- ([2-(tetrazol -1- yl) acetyl]amino) -5- thia -1- azabicyclo [4.2.0] oct-2-ene -2- carboxylate.

It should have been stored below 30 °C and away from light, especially UV. All of the rings can rearrange or decompose readily. The Thiadiazol and thiaazabicyclo are not stable to heat or light.

It must be assumed that the decomposition products in this particular bottle are such that they are no longer water soluble. For example if the molecule would split near the ring with the carboxylate group, a very large non-aqueous soluble organic would be formed.

can I drink alcohol while taking Cefazolin?,

You shouldnt drink alcohol with any medication!

Is there a home remedy for getting rid of stuffy noses on kittens?, My Kitty had been sneezing and had a watery eye I took her to the vet and he said she had Upper Respiatory infection, he perscribed amoxicillin drops and he gave her a cefazolin injection. It's been a week and it seems to be getting better but she still has a stuffed nostrol and she'll still sneeze and her eye is still watery. Is their some kind of a home remedy or something I can buy to help her breath?

No. continue on the antibiotics as prescribed. do not skip doses and do not stop the mediction until all gone. If not better AFTER using ALL the medication then call your vet.

my 5 mo pup has provo, been 2 vet, doing home care 4 the last 4 days with iv meds, still sick, what 2 do?, puppy had 2 series shot, he weighs 7 pounds, he has had 1000 units of antiboctic, cefazolin.reglane,b6.and vit c meds in him,finished them 12 pm today, he dranked a little water , butt hasnt touch none since 3 pm today, he hasnt eat either yet, he just puked again

Parvo will keep him sick for about 14 days. He will seem to get better, (playful/not vomiting) then he will seem worse. That's normal.

Go to the baby aisle of the grocery store and get Pedialyte, meat baby food (lamb and turkey is best) and a medicine shooter. The kind that looks like a syringe.

Mix the baby food in with the Pedialyte until it's liquid. Use the medicine shooter to put the mixture in the back of his mouth on the OUTSIDE of his teeth. Go slow, you can drown him by mistake.

Dehydration kills.
You need to get as much of the mixture into him as possible. You can't give him too much. Consider giving him doses a few times around the clock. Normally, I would say it's not necessary, but because you have such a little dog, and he is VERY sick, you should get up and do it about every 3 hours around the clock.

I can't stress enough that you need to get all the fluids (water and Pedialyte) into him as you can. He will die quickly unless you "force feed" him.

He will puke it up, he will produce his weight in diarrhea. KEEP GIVING IT TO HIM!!!

Antibiotics aren't strictly necessary at this point. They won't kill the Parvo, they just prevent other sicknesses while the pup is so sick. Keep him indoors, warm and as quiet as you can. He needs rest.

Parvo is contagious. You know that, but for the next year, (yes, YEAR) all dogs and puppies that come to your house have to be vaccinated. Parvo lives a long time in the environment. Clean vomit and diarrhea with diluted bleach.

When he's well, vaccinate him. There are other "puppy killers" out there, and you want to protect him.

I am recovery from staph infection in my knee qo daysago?, Hello,
I had emergency surgery on my knee for a staph infection. I spent three days in the hospital then released. I was getting vanco for the week now on cefazolin self infusion four times a day. I still feel weak and the smallest activities get me tired. How long will it be before I feel myslef and is this expected? Thank you Karl

I had Staph in my right knee some years ago! It took me over two months to use my knee properly again. About a month before my energy resumed.

pls help me,10 points for best answer,i have pain?, hi all.look i have a bad feeling behind my head and its particualry in left side of my head,its not like pain but seems its itchy from inside i have itchy feeling in my throat and left ear aswell,i have pain in my neck ,sometimes i feel pain in center and right part of my head a kind of pain that shocks me and vanishes soon,the pain continues in to my eyes,and rarely i feel pain in my arm and feet,i had temprature changes i have gone to doctor my medication just finished and nothing yet the doc said its an infection but common i took three pages of amoxi cilin and 3 ampulas of cefazolin how come its not ok yet?i scare can it be brain tumor?or what please if you ever had same expereince let me know,i dont wanna die,i have told my father to take me to nurologist but it takes time couse ct scan and mri scan are probable and they are expensive he cant afford it i gotta wait till next week help me

Sounds like maybe a sinus infection. You have sinuses on your forehead, under your eyes and around your nose. If you are not taking a decongestant you will never drain. The pain in other parts of your body may be related to your fever. Antibiotics take up to 1 week to really work- plus you may not be on the right one.

what does it mean "Esch Coli isolated" in a infant's stool culture report?, i have a 3 month old baby who's suffering from diarhhea like symptoms. A Paedetrician had advised me to get a stool culture test done. I did and the test report says

Org 1: Esch Coli Isolated

Antibiogram

SENSITIVE TO:

Imipenem
Amikacin
Piperacillin + Tazobactum

RESISTANT TO:

AMOXYCILLIN
AMPICILLIN
CEFAMANDOLE
CIPROFLOXACIN
CEFOTAXIME
CEFUROXIME
CEFAZOLIN...and many more medicines..I cant include all those...Please advise what does the report mean? I'm very much worried...

Thanks a lot

The Esch. coli harboured in the gut constitute a reservoir of potential pathogens in the infant and child. The conditions required for these intestinal inhabitants to cause infection are not well understood. The presence of virulence factors such as capsular antigens, especially K1, may be of significance for the ability of Esch. coli to cause neonatal meningitis. The capacity of certain Esch. coli to attach to epithelial cells of mucous membranes may be important for their infective powers in the urinary as well as the intestinal tract. Furthermore, the ability of certain Esch. coli to produce enterotoxins similar to that of V. cholerae is of importance for their capacity to provoke diarrhoea. The importance of the immune defence mechanisms for prevention of these Esch. coli infections is suggested, especially in the form of local immunity provided by secretory IgA antibodies. Such antibodies directed against Esch. coli O and K antigens as well as enterotoxins are present in large amounts in human milk and may be of considerable importance for protection against Esch. coli in the breast- fed baby. Breast feeding may be of special significance until the baby has built up its own local immune defence preventing the micro- organisms from attaching to and invading the intestinal mucous membranes. SIgA antibodies in urine may have a similar protective effect against urinary tract infections. The variable pictures of Esch. coli infections in childhood are striking, ranging from severe sepsis/meningitis or diarrhoea to "asymptomatic" bacteriuria. This variability is obviously closely connected with the presence of various virulence factors and the function of different components of the immune defence.
IN A NUT SHELL, E. COLI WAS FOUND IN YOUR CHILD'S STOOL SAMPLE,
ISOLATED CASE? MAYBE.....MEANING NO ONE ELSE IN THE HOUSE HAS IT?

pls help me its uregent why doesnt anyone answer my questions?, hi all.look i have a bad feeling behind my head and its particualry in left side of my head,its not like pain but seems its itchy from inside i have itchy feeling in my throat and left ear aswell,i have pain in my neck ,sometimes i feel pain in center and right part of my head a kind of pain that shocks me and vanishes soon,the pain continues in to my eyes,and rarely i feel pain in my arm and feet,i had temprature changes i have gone to doctor my medication just finished and nothing yet the doc said its an infection but common i took three pages of amoxi cilin and 3 ampulas of cefazolin how come its not ok yet?i scare can it be brain tumor?or what please if you ever had same expereince let me know,i dont wanna die,i have told my father to take me to nurologist but it takes time couse ct scan and mri scan are probable and they are expensive he cant afford it i gotta wait till next week help me

Please go to the doctor. No one here can really help - just give you our advice. Start with a general practitioner for a second opinion who may or may not suggest going to a specialist. It isn't worth the money you save if your health is at stake.

And don't assume the worst - you could have something less serious like migraines or an infection that just needs more antibiotics. Panicking will generally make any symptoms you have worse.

Good luck!

Asian Fetish?, For example i am trying to remember that cepahlexin, cephalothin, cephapirin and cephradine are all 1st generation cephalosporins that start with cep and the cef are cefazolin and cefadroxil. It is hard work but I believe those long nights with this special asian lady in my arms near a fireplace on a sofa while it is snowing outside makes it all worth it.

so.. do i have asian fetish?

I dunno. That's up to you.