Ancef

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• probenecid (Probalan, Benemid)
• methotrexate (Rheumatrex, Trexall)
• birth control pills

This is not a complete list of Ancef drug interactions. Ask your doctor or pharmacist for more information.

Antibacterial; β-lactam antibiotic; first generation cephalosporin.100 115 116 117 119 a

Biliary Tract Infections

Treatment of biliary tract infections caused by susceptible Escherichia coli,100 115 116 117 119 Klebsiella,115 116 Proteus mirabilis,100 115 116 117 119 Staphylococcus aureus,100 115 116 117 119 or various streptococci.100 115 116 117 119

Bone and Joint Infections

Treatment of bone and joint infections caused by susceptible S. aureus.100 115 116 117 119

Endocarditis

Treatment of endocarditis caused by susceptible Streptococcus pyogenes.100 113 114 115 116 117 119 AHA recommends cefazolin as an alternative for treatment of staphylococcal endocarditis113 114 or endocarditis caused by viridans streptococci†, S. bovis†, S. pneumoniae†, S. pyogenes, or groups B, C, and G streptococci† in penicillin-allergic individuals; should not be used in those with immediate-type penicillin hypersensitivity (see Cross-hypersensitivity under Cautions).113

Alternative for prevention of α-hemolytic (viridans group) streptococcal endocarditis† in individuals undergoing certain dental or upper respiratory tract procedures who have cardiac conditions that put them at highest risk.104 Oral amoxicillin is usual drug of choice for such prophylaxis;104 cefazolin (or ceftriaxone) is an alternative in penicillin-allergic individuals or when an oral anti-infective cannot be used.104 Should not be used in those with immediate-type penicillin hypersensitivity (see Cross-hypersensitivity under Cautions).104 Consult most recent AHA recommendations for specific information on which cardiac conditions are associated with highest risk of endocarditis and which procedures require prophylaxis.104

Respiratory Tract Infections

Treatment of respiratory infections caused by susceptible S. pneumoniae,100 115 116 117 119 S. pyogenes (group A β-hemolytic streptococci),100 115 116 117 119 S. aureus (including penicillin-resistant strains),100 115 116 117 119 Klebsiella,115 116 or Haemophilus influenzae.115 116

Septicemia

Treatment of septicemia caused by susceptible S. pneumoniae,100 115 116 117 119 S. aureus (including penicillinase-producing strains),100 115 116 117 119 E. coli,100 115 116 117 119 Klebsiella,115 116 or P. mirabilis.100 115 116 117 119

Skin and Skin Structure Infections

Treatment of skin and skin structure infections caused by susceptible S. aureus (including penicillinase-producing strains),100 115 116 117 119 S. pyogenes,100 115 116 117 119 or other streptococci.100 115 116 117 119

Urinary Tract Infections (UTIs) and Urogenital Infections

Treatment of UTIs caused by susceptible E. coli,100 115 116 117 119 P. mirabilis,115 116 117 119 Klebsiella,115 116 some strains of Enterobacter,115 116 or some strains of enterococci.115 116

Treatment of prostatitis or epididymitis caused by susceptible E. coli,100 115 116 117 119 Klebsiella,115 116 P. mirabilis,100 115 116 117 115 116 119 or some strains of enterococci.115 116

Prevention of Perinatal Group B Streptococcal Disease

Alternative to penicillin G or ampicillin for prevention of perinatal group B streptococcal (GBS) disease† (early-onset neonatal GBS disease) in penicillin-allergic pregnant women who do not have immediate-type penicillin hypersensitivity (see Cross-hypersensitivity under Cautions).111

Intrapartum anti-infective prophylaxis to prevent early-onset neonatal GBS disease is indicated in women identified as GBS carriers during routine prenatal GBS screening (vaginal and rectal cultures) performed at 35–37 weeks during the current pregnancy, women who have GBS bacteriuria identified at any time during the current pregnancy, and women with a previous infant diagnosed with invasive GBS disease.111

Prophylaxis also indicated in women with unknown GBS status at onset of labor (i.e., culture not done, incomplete, or results unknown) if delivery is at <37 weeks of gestation, duration of amniotic membrane rupture is ≥18 hours, intrapartum temperature is ≥38°C, or woman has a positive intrapartum GBS nucleic acid amplification test (NAAT).111

Perioperative Prophylaxis

Perioperative prophylaxis to reduce incidence of infection in patients undergoing certain cardiac surgery, noncardiac thoracic surgery, vascular surgery, head and neck surgery, neurosurgery, orthopedic surgery, GI surgery, GU surgery, and gynecologic and obstetric surgery.100 102 106 107 108 109 110 115 116 117 119

Drug of choice for perioperative prophylaxis for a wide variety of contaminated or potentially contaminated surgical procedures.102 103 Also recommended as drug of choice for perioperative prophylaxis for heart, lung, heart-lung, pancreas, and pancreas-kidney transplantation.103

For perioperative prophylaxis in patients undergoing certain GI procedures (e.g., colorectal surgery, appendectomy) that might involve exposure to Bacteroides fragilis or other anaerobic bowel bacteria or in patients undergoing head and neck surgery involving incisions through oral or pharyngeal mucosa; used in conjunction with metronidazole to provide anaerobic coverage.102 103

Consult published guidelines and protocols for perioperative prophylaxis for recommendations regarding specific procedures.102 103

Absorption

Bioavailability

Not appreciably absorbed from GI tract; must be administered parenterally.100

After IM injection, peak serum concentrations attained within 1–2 hours.a

Distribution

Extent

Widely distributed into tissues and fluids,a including synovial fluid.100

Only low concentrations distribute into CSF.a

Crosses the placenta100 and is distributed into milk.100

Plasma Protein Binding

74–86%.a

Elimination

Metabolism

Not appreciably metabolized.a

Elimination Route

Excreted unchanged in urine.100 Approximately 60% of a dose excreted within 6 hours and 70–80% excreted within 24 hours in those with normal renal impairment.100

Half-life

Serum half-life approximately 1.8 hours after IV administration and 2 hours after IM administration.100

Special Populations

Half-life increased in renal impairment.100

• Based on spectrum of activity, classified as a first generation cephalosporin.a Has a limited spectrum of activity compared with second, third, and fourth generation cephalosporins.a

• Usually bactericidal.a

• Like other β-lactam antibiotics, antibacterial activity results from inhibition of bacterial cell wall synthesis.100 a

• Spectrum of activity includes many gram-positive aerobic bacteria and some gram-negative aerobic bacteria; inactive against fungi and viruses.100 a

• Gram-positive aerobes: active in vitro and in clinical infections against penicillinase-producing and nonpenicillinase-producing Staphylococcus aureus and S. epidermidis; Streptococcus pyogenes (group A β-hemolytic streptococci); S. agalactiae (group B streptococci); and S. pneumoniae.a 100 Enterococci and methicillin-resistant (oxacillin-resistant) staphylococci are resistant.100

• Gram-negative aerobes: active in vitro and in clinical infections against some strains of Haemophilus influenzae, Escherichia coli, Klebsiella, Proteus mirabilis, and Enterobacter aerogenes.100 a Inactive against most other gram-negative bacteria, including Citrobacter, E. cloacae, Morganella, Providencia, Pseudomonas, and Serratia.100 a

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Cefazolin is used to treat bacterial infections in many different parts of the body. This medicine is also given before certain types of surgery to prevent infections.

Cefazolin belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

A nurse or other trained health professional will give you this medicine. This medicine is given as a shot into one of your muscles or through a needle placed in one of your veins.

Ancef is indicated in the treatment of the following infections due to susceptible organisms:

Respiratory Tract Infections

Due to S. pneumoniae, S aureus (including β-lactamase−producing strains) and S. pyogenes.

Injectable benzathine penicillin is considered to be the drug of choice in treatment and prevention of streptococcal infections, including the prophylaxis of rheumatic fever.

Ancef is effective in the eradication of streptococci from the nasopharynx; however, data establishing the efficacy of Ancef in the subsequent prevention of rheumatic fever are not available.

Urinary Tract Infections

Due to E. coli, P mirabilis.

Skin and Skin Structure Infections

Due to S. aureus (including β-lactamase−producing strains), S. pyogenes, and other strains of streptococci.

Biliary Tract Infections

Due to E. coli, various strains of streptococci, P. mirabilis, and S. aureus.

Bone and Joint Infections

Due to S. aureus.

Genital Infections

(i.e., prostatitis, epididymitis) due to E. coli, P. mirabilis.

Septicemia

Due to S. pneumoniae, S. aureus (including β-lactamase−producing strains), P. mirabilis, E. coli.

Endocarditis

Due to S. aureus (including β-lactamase−producing strains) and S. pyogenes.

Appropriate culture and susceptibility studies should be performed to determine susceptibility of the causative organism to Ancef.

Perioperative Prophylaxis

The prophylactic administration of Ancef preoperatively, intraoperatively, and postoperatively may reduce the incidence of certain postoperative infections in patients undergoing surgical procedures which are classified as contaminated or potentially contaminated (e.g., vaginal hysterectomy, and cholecystectomy in high-risk patients such as those older than 70 years, with acute cholecystitis, obstructive jaundice, or common duct bile stones).

The perioperative use of Ancef may also be effective in surgical patients in whom infection at the operative site would present a serious risk (e.g., during open-heart surgery and prosthetic arthroplasty).

The prophylactic administration of Ancef should usually be discontinued within a 24-hour period after the surgical procedure. In surgery where the occurrence of infection may be particularly devastating (e.g., open-heart surgery and prosthetic arthroplasty), the prophylactic administration of Ancef may be continued for 3 to 5 days following the completion of surgery.

If there are signs of infection, specimens for cultures should be obtained for the identification of the causative organism so that appropriate therapy may be instituted.

(See DOSAGE AND ADMINISTRATION.)

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ancef and other antibacterial drugs, Ancef should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Ancef

Single-Dose Vials

Each vial contains cefazolin sodium equivalent to 1 gram of cefazolin.

NDC 0007-3130-16 (package of 25 vials)

“Piggyback” Vials

Each vial contains cefazolin sodium equivalent to 1 gram of cefazolin.

NDC 0007-3137-05 (package of 10 "piggyback" vials)

Pharmacy Bulk Vials

Each vial contains cefazolin sodium equivalent to 10 grams of cefazolin.

NDC 0007-3135-05 (package of 10 pharmacy bulk vials)

As with other cephalosporins, Ancef tends to darken depending on storage conditions; within the stated recommendations, however, product potency is not adversely affected.

Before reconstitution protect from light and store at Controlled Room Temperature 20° to 25°C (68° to 77°F).