Cefazolin adverse effects

In another reported incident, a pharmacist ordered the 10-g vials of cefazolin sodium but received the 1-g vials in error. Intending to reconstitute and divide the 10-g vials into 1-g doses, a technician inadvertently reconstituted the 1-g vials and proceeded to divide the total solution of each vial into ten 100-mg doses. Some of the prepared 100-mg doses of cefazolin sodium were administered to patients instead of their scheduled 1-g doses, but no adverse effects were reported. The pharmacist thought that the error occurred partly because the vials are identical in size and have similar labels. 

The adverse effects associated with cefazolin are generally similar to those described for penicillins. Cefazolin contains a methylthiodiazolethiol side chain and may further cause hypoprothrombinemia and a disulfiram-like reaction with alcohol similar to that seen witli cephalosporins containing the related A-methyl-thiotetrazole side chain. 

Cephalosporins distribute into most body fluids and tissues, including pleural fluid, synovial fluid, pericardial fluid and urine. Cephalosporins distribute into milk, but therapeutic concentrations are not reached following systemic administration at accepted dose rates. Cephalosporins cross the placenta but do not appear to cause adverse effects in the fetus. Their penetration into cortical and cancellous bone is usually adequate. Most cephalosporins penetrate poorly into the aqueous humor, accessory sex glands and CSF. Cephalosporins have typically low values in horses 0.191/kg for cefazolin, 0.151/kg for cefa-lotin, 0.171/kg for cefapirin, 0.41/kg for cefradine and 0.121/kg for cefoxitin. 

Cefazolin has been associated with drug fever, neutropenia and thrombocytopenia. A case of a 21-year-old previously healthy male admitted with anterior wall laceration and administered cefazolin as preoperative and postoperative prophylaxis illustrates a case of all three of these potential adverse effects [52 ]. 

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