What is the use of Ancef (Cefazolin)?

From the Guidelines

Ancef (cefazolin) is a first-generation cephalosporin antibiotic that should be used with caution due to its limited coverage against MRSA, Enterococcus, and many resistant gram-negative bacteria, and its potential for cross-reactivity in patients with severe penicillin allergies, as noted in studies such as 1 and 1.

Key Points

• The typical adult dose of Ancef is 1-2 grams intravenously every 8 hours, with adjustments needed for patients with kidney impairment, as seen in 1.
• For surgical prophylaxis, a single 1-2 gram dose is usually given within 60 minutes before incision, with additional doses for longer procedures, as recommended in 1.
• Ancef effectively treats many gram-positive bacteria (including Staphylococcus aureus) and some gram-negative organisms, but its use should be guided by local resistance patterns and patient-specific factors, as discussed in 1 and 1.
• Common side effects include diarrhea, rash, and allergic reactions, and dosing adjustments are necessary for patients with creatinine clearance below 55 mL/min, as noted in 1.

Considerations

• Patients with severe penicillin allergies may experience cross-reactivity, and alternative antibiotics should be considered, as discussed in 1 and 1.
• Ancef requires reconstitution before administration and is typically given intravenously, though intramuscular administration is possible for certain situations, as seen in 1.
• The choice of antibiotic therapy should take into account the type of infection, the severity of the infection, and the patient's history of prior antimicrobial exposure, as recommended in 1 and 1.

Recommendations

• For mild to moderately severe infections, Ancef may be considered as part of a combination therapy, such as with metronidazole, as noted in 1 and 1.
• For severe infections, alternative antibiotics with broader coverage, such as piperacillin-tazobactam or meropenem, may be preferred, as discussed in 1 and 1.
• Vancomycin may be added for patients with concerns about MRSA infection, as recommended in 1.

From the FDA Drug Label

Cefazolin for Injection, USP is indicated in the treatment of the following serious infections due to susceptible organisms: The prophylactic administration of Cefazolin for Injection, USP preoperatively, intraoperatively, and postoperatively may reduce the incidence of certain postoperative infections in patients undergoing surgical procedures which are classified as contaminated or potentially contaminated

Ancef (Cefazolin) is used for the treatment of various serious infections and as a perioperative prophylaxis to reduce the incidence of certain postoperative infections in patients undergoing surgical procedures. The specific infections it is indicated for include:

• Respiratory Tract Infections
• Urinary Tract Infections
• Skin and Skin Structure Infections
• Biliary Tract Infections
• Bone and Joint Infections
• Genital Infections
• Septicemia
• Endocarditis 2

From the Research

Ancef Overview

• Ancef, also known as cefazolin, is a cephalosporin antibiotic used for surgical prophylaxis to prevent surgical site infections (SSIs) 3.
• It is considered the drug of choice for surgical prophylaxis due to its effectiveness and lower risk of allergic reactions compared to other antibiotics 3.

Efficacy and Safety

• Studies have shown that cefazolin is effective in preventing SSIs in various surgical procedures, including orthopaedic oncology 4 and general surgery 5, 6.
• Cefazolin has been found to be safe for use in patients with penicillin allergy labels, with no increased risk of severe allergic reactions 5, 6.
• A study found that cefazolin 2g was effective in preventing SSIs in obese patients, with no significant difference in SSI rates compared to non-obese patients 7.

Administration and Dosage

• Cefazolin should be administered as a single dose, 30 minutes to 1 hour before surgery, to ensure effective concentrations in the blood and tissue during and shortly after the procedure 3, 4.
• The recommended dose of cefazolin is 2g for adult patients, with no need for dose adjustment in obese patients 7.
• A second dose may be advisable if surgery is delayed or prolonged, especially if an antimicrobial drug with a short half-life is used 3.

Comparison to Other Antibiotics

• Cefazolin has been compared to other antibiotics, such as vancomycin and clindamycin, and has been found to be associated with better patient outcomes and lower rates of SSIs 5, 6.
• Cefazolin is generally preferred over other cephalosporins, such as cefuroxime and cefoxitin, due to its stronger antistaphylococcal activity and lower risk of allergic reactions 3.