Cefazedone

General

• Type: 1st generation Cephalosporin
• Dosage Forms: powder for injection
• Dosage Strengths: 500mg, 1g, 2g
• Routes of Administration: IV, IM
• Common Trade Names: Refosporen

Adult Dosing

General

• Mild-Moderate: 1-2g/day IM/IV divided q8-12h
• Severe: 2-4g/day IM/IV divided q6-8h
• Life Threatening: Up to 6g/day IM/IV
• Max: 6g/day

UTI, Uncomplicated

• 500mg-1g IM/IV q12h

Surgical Prophylaxis

• 1g IM/IV x1 (30-60 min before procedure)
• May repeat q6h for 24-48h post-op depending on procedure

Pediatric Dosing

General (>1 Month)

• Mild-Moderate: 50mg/kg/day IM/IV divided q8-12h
• Severe: 100mg/kg/day IM/IV divided q6-8h
• Max: Should not exceed adult dosing

Special Populations

• Pregnancy: B
• Lactation: Low excretion; generally considered compatible
• Renal
  • Adult
    • CrCl 30-60: give q12h
    • CrCl 10-29: give q24h
    • CrCl <10: give q48h
    • Hemodialysis: give dose after dialysis
    • Peritoneal dialysis: give standard dose q24-48h
  • Pediatric
    • Renal dosing not well defined; adjust based on adult ratios
• Hepatic
  • Not defined

Contraindications

• Allergy to class/drug (Cephalosporins)
• Immediate hypersensitivity to Penicillins

Adverse Reactions

Serious

• Anaphylaxis
• Stevens-Johnson Syndrome
• Neutropenia (prolonged high doses)
• Thrombocytopenia
• Clostridium difficile associated diarrhea
• Nephrotoxicity (rare, increased risk with loop diuretics/aminoglycosides)
• Seizures (accumulation in renal failure)

Common

• Diarrhea
• Rash
• Nausea and Vomiting
• Abdominal Pain
• Phlebitis at injection site
• Pain at injection site (IM)
• Transaminitis
• Eosinophilia

Pharmacology

• Half-life: 1.5 - 2h (prolonged in renal failure)
• Metabolism: Minimally metabolized
• Excretion: Urine (80-90% unchanged)
• Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities

Group	Organism	Sensitivity
Gram Positive	Strep. Group A, B, C, G	S
	Strep. Pneumoniae	S
	Viridans strep	S
	Strep. anginosus gp	X1
	Enterococcus faecalis	R
	Enterococcus faecium	R
	MSSA	S
	MRSA	R
	CA-MRSA	R
	Staph. Epidermidis	I
	C. jeikeium	R
	L. monocytogenes	R
Gram Negatives	N. gonorrhoeae	X1
	N. meningitidis	R
	Moraxella catarrhalis	I
	H. influenzae	X1
	E. coli	S
	Klebsiella sp	S
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	R
	Enterobacter sp, AmpC pos	R
	Serratia sp	R
	Serratia marcescens	R
	Salmonella sp	X1
	Shigella sp	X1
	Proteus mirabilis	S
	Proteus vulgaris	R
	Providencia sp.	R
	Morganella sp.	R
	Citrobacter freundii	R
	Citrobacter diversus	R
	Citrobacter sp.	R
	Aeromonas sp	R
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	R
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	X1
	Haemophilus ducreyi	X1
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	X1
	Mycoplasm pneumoniae	X1
	Rickettsia sp	X1
	Mycobacterium avium	X1
Anaerobes	Actinomyces	X1
	Bacteroides fragilis	R
	Prevotella melaninogenica	X1
	Clostridium difficile	X1
	Clostridium (not difficile)	I
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	S

Key

• S susceptible/sensitive (usually)
• I intermediate (variably susceptible/resistant)
• R resistant (or not effective clinically)
• S+ synergistic with cell wall antibiotics
• U sensitive for UTI only (non systemic infection)
• X1 no data
• X2 active in vitro, but not used clinically
• X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
• X4 active in vitro, but not clinically effective for strep pneumonia

See Also

• Antibiotics (Main)
• Cephalosporins

References

• Epocrates