Disease relevance of cefazolin

• Cefazolin and Staphylococcus aureus endocarditis [1].
• Unsuccessful treatment of staphylococcal endocarditis with cefazolin [2].
• Cefazolin vs penicillin. Treatment of uncomplicated pneumococcal pneumonia [3].
• To determine the efficacy of perioperative cefazolin in preventing pelvic and wound infections after elective non-radical hysterectomy, a randomised, placebo-controlled, double-blind clinical trial was done [4].
• Among 429 women having abdominal hysterectomy, the 206 who received cefazolin had significantly lower rates of wound and pelvic infections (21% vs. 14%), UTI (21% vs. 9%), and febrile morbidity (20% vs. 14%) [4].

Psychiatry related information on cefazolin

• It was the authors' and nurses' observation that patient compliance and satisfaction was better with vancomycin, and the cost per treatment was 23% less than cefazolin [5].
• Acute confusional state with postoperative intravenous cefazolin [6].
• Similarly cefazolin, given into the caudate nucleus produced contralateral circling, an increase locomotor activity, myoclonic jerks of contralateral limbs, intense stereotyped behavior and occasionally generalized clonic convulsions [7].

High impact information on cefazolin

• Staphylococcus aureus isolates that produced the A and C variants of staphylococcal beta-lactamase were associated with infections following cefazolin and cefamandole prophylaxis, respectively [8].
• The second patient had concomitant central nervous system infection and failed to respond to cefazolin therapy [2].
• Among 86 patients undergoing vaginal hysterectomy, those who received three perioperative 1 g doses of cefazolin (44) had significantly fewer pelvic infections (21% vs. 2%); less standard febrile morbidity (31% vs. 14%); shorter length of stay (LOS); and fewer courses of antibiotics postoperatively [4].
• The important differences between cefazolin and cephalothin--and this is also probably true with respect to cephapirin and cephradine--are not in therapeutic effectiveness, microbiologic activity, or toxicity but rather in pharmacokinetics and cost-effectiveness [9].
• Long half-life for cefazolin in anuria [10].

Chemical compound and disease context of cefazolin

• It is concluded that the current empiric dosing recommendations for PD-related peritonitis may be adequate for cefazolin (15 to 20 mg/kg); however, tobramycin doses must be changed to 1.5 mg/kg intraperitoneally on day 1, then to 0.5 mg/kg intraperitoneally thereafter in APD patients [11].
• Recurrence rates with osteomyelitis associated with S. aureus appear to be higher with the use of vancomycin, whereas ceftriaxone and cefazolin appear to be similar to penicillinase-resistant penicillins [12].
• In a randomized and controlled clinical trial, the safety and effectiveness of ticarcillin plus clavulanate potassium and cefazolin were compared in the treatment of soft tissue infections in 20 patients [13].
• We studied single-dose cefazolin (CFZ) and cephalexin (CPX) kinetics in continuous ambulatory peritoneal dialysis (CAPD) patients to establish therapeutic guidelines for two cephalosporins commonly used to treat peritonitis in these patients [14].
• A single dose of daptomycin also was more effective in prevention of staphylococcal and enterococcal endocarditis than were single-dose regimens of cefazolin (100 mg/kg) and the combination of ampicillin (30 mg/kg) plus gentamicin (3 mg/kg), respectively [15].

Biological context of cefazolin

• A breif perioperative course of cefazolin and povidone-iodine skin antisepsis are recommended in vascular reconstructive surgery of the abdominal aorta and lower extremity vasculature [16].
• Intraoperative redosing of cefazolin and risk for surgical site infection in cardiac surgery [17].
• Cefazolin kinetics was studied in 8 patients the day before (PREOP), during (SURG), and the day after (POSTOP) cardiopulmonary bypass (CPB) surgery [18].
• Protein binding of cefazolin and gentamicin in sera and wound fluids was low (less than or equal to 29 +/- 9%) in this canine model [19].
• Effects of general and local anesthesia on the pharmacokinetics of cefazolin in patients undergoing orthopedic surgery [20].

Anatomical context of cefazolin

• The cerebrospinal fluid IgG index was elevated, specific IgG-ceftazidime binding was shown, and skin allergy testing with cefazolin provoked a recurrence of meningitis [21].
• Ceftriaxone given once-a-day was compared with cefazolin given three times daily as therapy for complicated and uncomplicated urinary tract infections [22].
• Among the 462 patients undergoing surgery of the abdominal aorta and lower extremity vasculature, there was a highly significant difference in the infection rates: 6.8% for placebo recipients versus 0.9% for cefazolin recipients (p less than .001) [16].
• This agent acts synergistically with many penicillins, such as ampicillin, carbenicillin, and the like, and with cephalosporins, cefazolin, cefamandole, or cefoxitin to inhibit gram-negative bacilli, probably on the basis of binding to different proteins needed for the production of the peptidoglycan of the bacterial cell wall [23].
• We used decision-analytic models to compare clinical results and cost-effectiveness of no prophylaxis, cefazolin, and vancomycin, in coronary artery bypass graft surgery [24].

Associations of cefazolin with other chemical compounds

• The correlation between in vitro results and bacteriologic outcome in patients treated with ceftriaxone was equivalent or superior to that achieved in patients treated with the comparative agents cefamandole and cefazolin [25].
• The results demonstrate that ceftriaxone compares favorably with cefazolin and is effective when given once-a-day for both complicated and uncomplicated urinary tract infections [22].
• Pharmacokinetics of intermittent intravenous cefazolin and tobramycin in patients treated with automated peritoneal dialysis [11].
• Following microsurgical cannulation of the right lymphatic duct in 28 healthy rabbits, either penicillin-G, nafcillin, erythromycin, or cefazolin was given intramuscularly, and lymph and serum samples obtained at frequent intervals [26].
• However, when the animals were treated at intervals of 6 hr for four days, significantly fewer rabbits survived after treatment with cefazolin than with cephalothin [27].

Gene context of cefazolin

• We conclude that type A blaZ is common in MSSA PJI and that cefazolin therapy for blaZ MSSA PJI can be successful when combined with 2-stage reimplantation and local antimicrobial therapy [28].
• A simulated 1-g dose of cefazolin was ineffective in reducing the bacterial counts in blood and peritoneal fluid samples of animals infected with S. marcescens US20, which produced class Ia beta-lactamase, and as a result, mortality was similar to that of infected controls [29].
• Peptidoglycan of MRSA grown in the presence of cefazolin was susceptible to lysis by respiratory mucus [30].
• Moreover, transport of cefazolin by hOAT1 and hOAT3 were examined using HEK293 transfectants [31].
• These observations also raise the possibility that the TPMT genetic polymorphism may represent a risk factor for cefazolin-induced hypoprothrombinemia since subjects who genetically lack TPMT would be unable to catalyze this MTD biotransformation pathway [32].

Analytical, diagnostic and therapeutic context of cefazolin

• In abdominal hysterectomy, cefazolin decreased in-hospital morbidity from 43% to 25% (preventive fraction, 42%), resulting in an average net savings of +102 per patient [33].
• In patients undergoing vaginal hysterectomy, prophylactic cefazolin reduced in-hospital infectious morbidity from 52% to 23% (preventive fraction, 56%), resulting in an average net benefit of +492 per patient [33].
• The effect of five days of antibiotic prophylaxis with cefazolin injections (beginning just before surgery) on postoperative infections (beginning just before surgery) on postoperative infectious complications was evaluated in a double-blind, randomised, placebo-controlled trial in nine centres on 2137 patients undergoing hip replacement [34].
• Long-term results of prophylactic cefazolin versus placebo in total hip replacement [35].
• Patients received either intravenous saline as a placebo or intravenous cefazolin (1 g) 30 minutes before gastrostomy [36].

References