Cefazolin (Surgical Prophylaxis)

How it works

It inhibits bacterial cell wall synthesis by binding penicillin-binding proteins, providing reliable activity against staphylococci and streptococci.

Prescribing in practice

• Give the prophylactic dose within the recommended window before surgical incision to ensure adequate tissue concentrations at the time of incision.
• Avoid or use with caution in patients with a history of severe penicillin or cephalosporin allergy and check local microbiology policy.
• Redosing during prolonged procedures or major blood loss may be required per local protocol.

Monitoring

Monitor for hypersensitivity reactions and, with prolonged use, renal function and signs of antibiotic-associated diarrhoea.

Counselling the patient

• Tell the team about any previous reactions to penicillins or cephalosporins before surgery.
• Report rash, breathlessness or swelling promptly as these may indicate allergy.
• Report severe or persistent diarrhoea after antibiotic use.

Evidence & guidelines

Cefazolin is recommended for surgical prophylaxis in many procedures by national guidance including NICE and SIGN.