Cefazolin (Perioperative Burns)

How it works

It binds penicillin-binding proteins to inhibit bacterial cell-wall peptidoglycan synthesis, giving reliable activity against staphylococci and streptococci that cause surgical-site infection.

Prescribing in practice

• Avoid in patients with a history of severe or immediate hypersensitivity to penicillins or cephalosporins, and use caution with any prior beta-lactam allergy.
• For prophylaxis it should be given so that adequate tissue concentrations are present at incision, with intra-operative re-dosing for prolonged procedures or major blood loss.
• Burns patients have altered, often increased, drug clearance and a large volume of distribution, so standard prophylactic exposure may be inadequate.

Monitoring

Monitor for hypersensitivity reactions and for surgical-site infection in the postoperative period.

Counselling the patient

• This antibiotic is given to lower the chance of wound infection around your operation.
• Tell the team about any previous reaction to penicillin or cephalosporin antibiotics.

Evidence & guidelines

Cefazolin is a guideline-recommended agent for surgical prophylaxis against skin-flora organisms across many procedure types.