Cefazolin

Lore & Background

It is on the World Health Organization's List of Essential Medicines and is available as a generic medication. It was initially marketed by GlaxoSmithKline under the trade name Nostof, with other trade names including Cefacidal, Cefamezin, Cefrina, Elzogram, Faxilen, Gramaxin, Kefol, Kefzol, Kefzolan, Kezolin, Novaporin, Reflin, Zinol, and Zolicef.

Reader's Guide

Cefazolin is a first-generation cephalosporin antibiotic that works by interfering with the bacteria's cell wall, specifically by binding penicillin-binding proteins to stop peptidoglycan synthesis, leading to bacterial lysis. It is active against many gram-positive bacteria, including methicillin-susceptible Staphylococcus aureus, and some gram-negative bacteria such as Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae. It does not penetrate the central nervous system and is not effective against meningitis, nor does it work against methicillin-resistant Staphylococcus aureus, Enterococcus, anaerobic bacteria, or atypical bacteria. Historically thought to be contraindicated in patients with penicillin allergies, several recent studies have refuted this, and it is proven safe in almost all patients, though a small chance of cross-reactivity remains. It is relatively safe for use during pregnancy and breastfeeding, and is often the preferred drug for surgical prophylaxis. Common side effects include diarrhea, vomiting, yeast infections, and rash. The chemical structure contains an N-methylthiodiazole side-chain that can cause hypoprothrombinemia and a reaction with ethanol similar to disulfiram.

Did You Know?

• It is on the World Health Organization's List of Essential Medicines.
• Cefazolin is not effective against meningitis because it does not penetrate the central nervous system.
• It is proven safe in almost all patients, including those with known penicillin allergies, despite historical concerns.