Antimicrobials

Active against:

• S. aureus (cloxacillin-sensitive strains)
• Streptococci
• Most strains of E. coli, Klebsiella, P. mirabilis
• Oral anaerobes

Not active against:

• Methicillin-resistant S. aureus (MRSA)
• Enterococci
• B. fragilis
• Listeria
• Certain species of gram-negative rods, including: Acinetobacter, Citrobacter, Enterobacter, H. influenza, Morganella, Providencia, Pseudomonas, Serratia

Appropriate Uses:

• Surgical prophylaxis
• Treatment of skin and soft tissue infections

• Severe S. aureus infection not due to MRSA

Inappropriate Uses:

• Meningitis and other CNS infections

• The potential for cross-reactivity exists among penicillins, cephalosporins and meropenem of approximately 1%
• Pregnancy: not expected to increase risk of major congenital malformations
• Breastfeeding: considered safe during breastfeeding. Monitor nursing infant for GI symptoms.

• Hypersensitivity: drug fever, skin rash, urticaria, anaphylaxis
• Hematologic: positive Coombs test, rarely thrombocytopenia, leukopenia
• Hepatic/Renal: transient rise in AST, ALT, and urea nitrogen (no clinical evidence of renal impairment)
• Gastrointestinal: nausea, vomiting, diarrhea, oral candidiasis, rarely pseudomembranous colitis
• CNS: seizures at high dosage in patients with end stage renal disease

IV therapy:

• Cefazolin 1-2 g IV q8h

• Dosing with 2 g is suggested for treatment of infective endocarditis, osteomyelitis, GNB infection, and in patients with weight > 80 kg

Oral Therapy:

• Cephalexin 500 mg PO QID

Renal insufficiency:

IV cefazolin: 

• Please refer to IV drug monograph on pharmacy intranet page for additional administration information.