First-lineKefzol
Cefazolin
1st-generation cephalosporin
Pre-incision prophylaxis at LSCS — reduces endometritis & wound infection >60%.
IV
First-line for
- LSCS surgical prophylaxis
- Hysterectomy prophylaxis
- GBS prophylaxis (non-anaphylactic penicillin allergy)
Mechanism
β-lactam; PBP binding — strong Gram-pos cover, modest Gram-neg.
“2 g IV within 60 min of skin incision”
- 3 g if BMI >40
- Re-dose at 4 h or blood loss >1.5 L
Dosing
- LSCS / hysterectomy
- 2 g IV (3 g if BMI >40) within 60 min pre-incision
- GBS
- 2 g IV load, then 1 g q8h
Contraindications
- AbsoluteIgE-mediated penicillin/cephalosporin anaphylaxis
- CautionNon-anaphylactic penicillin allergy — cross-reactivity ~1–2%
Side effects
- Diarrhoea
- Phlebitis
- Hypersensitivity
Fetal & maternal notes
- • Safe T1–T3 and lactation
Key interactions
Probenecid
OK↑ levels
Warfarin
CautionMild ↑ INR
Clinical pearls
- 💡 Give BEFORE skin incision, not after cord clamp (Cochrane 2014)
- 💡 Weight-based dosing is mandatory
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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