What is the maximum recommended dose of cefazolin (a cephalosporin antibiotic) for pediatric patients?

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Maximum Recommended Dose of Cefazolin for Pediatric Patients

The maximum recommended dose of cefazolin for pediatric patients is 150 mg/kg/day divided into three doses (every 8 hours), with no established absolute maximum daily dose in milligrams. 1

Dosing Guidelines for Cefazolin in Pediatric Patients

Standard Dosing

  • For most mild to moderately severe infections, the total daily dosage is 25 to 50 mg/kg of body weight, divided into 3 or 4 equal doses 2
  • For severe infections, the total daily dosage may be increased to 100 mg/kg of body weight 2
  • For methicillin-susceptible Staphylococcus aureus infections, the preferred dosage is 150 mg/kg/day divided every 8 hours 1

Specific Clinical Scenarios

  • For infective endocarditis in pediatric patients, cefazolin should be dosed at 100 mg/kg per 24 hours IV in 3 equally divided doses 1
  • For surgical prophylaxis, the FDA label recommends weight-based dosing following the standard 25-50 mg/kg/day approach 2
  • Recent research suggests that for surgical prophylaxis, children ≥50 kg should receive a 2-gram dose, while those between 25-50 kg should receive a 1-gram dose 3

Dosing Adjustments

Renal Impairment

  • For pediatric patients with mild to moderate renal impairment (creatinine clearance of 70 to 40 mL/min), 60% of the normal daily dose given in equally divided doses every 12 hours is recommended 2
  • For moderate impairment (creatinine clearance of 40 to 20 mL/min), 25% of the normal daily dose given in equally divided doses every 12 hours is adequate 2
  • For severe renal impairment (creatinine clearance of 20 to 5 mL/min), 10% of the normal daily dose every 24 hours may be given 2

Important Clinical Considerations

  • Safety for use in premature infants and neonates has not been established, so cefazolin is not recommended in these populations 2
  • All dosage recommendations apply after an initial loading dose appropriate to the severity of the infection 2
  • While some cephalosporins (like cefotaxime) have been studied with extended dosing intervals, cefazolin's pharmacokinetic profile generally requires more frequent dosing 4
  • The FDA label does not specify an absolute maximum daily dose in milligrams for pediatric patients, unlike some other antibiotics that have both weight-based and absolute maximum dose limits 2

Administration Considerations

  • For intravenous administration, reconstitute with Sterile Water for Injection according to the package insert guidelines 2
  • For direct (bolus) injection, further dilute with approximately 5 mL Sterile Water for Injection and inject slowly over 3 to 5 minutes 2
  • For intramuscular administration, reconstitute according to the dilution table in the package insert and inject into a large muscle mass 2

Monitoring

  • Monitor for adverse effects, which may include gastrointestinal symptoms and neutropenia 5
  • In critically ill children, be aware that cefazolin may have altered pharmacokinetics with faster clearance and larger volume of distribution, potentially requiring dose adjustments 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Ceftaroline for Suspected or Confirmed Invasive Methicillin-Resistant Staphylococcus aureus: A Pharmacokinetic Case Series.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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