세파졸린

항생제 - 1세대 세팔로스포린

세파졸린은 수의학에서 널리 사용되는 주사용 **1세대 세팔로스포린계** 항생제입니다. 동물용으로 FDA 승인을 받지는 않았지만, **외과 수술의 예방적 투여**(특히 정형외과 및 연부조직 수술) 및 패혈증을 포함한 전신 감염 치료에 임상적으로 매우 중요한 약물입니다. **임상 요점:** * **항균 스펙트럼:** 대부분의 그람 양성 병원균(예: *Staphylococcus intermedius*, 황색포도상구균, 연쇄상구균 속)에 대해 우수한 효과를 보이지만, 그람 음성 병원균에 대한 효과는 가변적이거나 떨어집니다. *Bacteroides fragilis*를 제외한 대부분의 혐기성 세균에 매우 효과적입니다. * **약력학:** **시간 의존성** 살균 항생제입니다. 효능은 투여 간격의 대부분 동안 감염 부위의 약물 농도를 최소 억제 농도(MIC) 이상으로 유지하는 것에 달려 있습니다. 이를 최적화하기 위해 지속적 정맥 주입(CRI) 프로토콜이 점점 더 많이 활용되고 있습니다. * **투여 방법:** 경구로는 거의 흡수되지 않으므로 반드시 비경구(IV, IM, SC, IO)로 투여해야 합니다. 부작용을 최소화하기 위해 정맥 주사는 3~5분에 걸쳐 천천히 투여해야 합니다.

작용 기전: Cefazolin is a **bactericidal beta-lactam antibiotic**. **Mechanism of Action:** * **Target:** Binds to specific **Penicillin-Binding Proteins (PBPs)** located inside the bacterial cell wall. * **Pathway:** Beta-lactam ring binds PBPs → Inhibition of the transpeptidation enzyme → Prevention of peptidoglycan cross-linking → Weakening of the bacterial cell wall. * **Result:** The defective cell wall makes the bacteria highly susceptible to osmotic pressure, leading to **cell lysis** and death. As a time-dependent antibiotic, its bacterial killing is maximized by optimizing the duration of time that free drug concentrations remain above the MIC (T > MIC).

동물 종별 용량

Cats

Gram-positive infections · 10 mg/kg or 10-30 mg/kg · IV, IM · q8h · 10 mg/kg IV or IM q8h; OR 10-30 mg/kg IV q8h
Gram-negative infections · 30 mg/kg or 10-30 mg/kg · IM, SC, IV · q8h · 30 mg/kg IM or SC; OR 10-30 mg/kg IV q8h
Surgical prophylaxis (Orthopedic procedures) · 20 mg/kg at induction followed by 20 mg/kg every 90 minutes until wound closure · IV · q90m · Perioperative
Surgical prophylaxis (Soft tissue surgery) · 20 mg/kg at time of surgery followed by a second dose of 20 mg/kg 6 hours later · IV/SC · Once then 6 hours later · Perioperative · First dose IV, second dose SC
Sepsis · 20-25 mg/kg · IV · q4-8h
Systemic infections · 33 mg/kg · IV, IM · q8-12h · As long as necessary
Susceptible infections · 20-25 mg/kg · IM, IV · q8h
Infections in neonates · 10-30 mg/kg · IV, IO · q8h

Horses

Susceptible infections · 25 mg/kg · IV, IM · q6h
Susceptible infections · 25 mg/kg · IV, IM · q6-8h
Susceptible infections (Foals) · 20 mg/kg · IV · q8-12h

투여 경로

IVIMSCIO

금기

Patients with a known history of hypersensitivity to cephalosporins

이상반응

Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
Pain at the IM injection site
Sterile abscesses or local tissue reactions (rare)
Thrombophlebitis (following IV administration)
Nephrotoxicity (minimal risk at clinical doses)
Neurotoxicity or seizures (associated with very high IV doses)
GI flora disruption (in nursing neonates)

약물 상호작용

Aminoglycosides · Potential for additive nephrotoxicity; use concurrently with caution.
Amphotericin B · Potential for additive nephrotoxicity; use concurrently with caution.
Probenecid · Competitively blocks the renal tubular secretion of cefazolin, thereby increasing serum levels and prolonging the elimination half-life.

모니터링

Clinical efficacy (resolution of clinical signs, normalization of WBC count, fever reduction)
Renal function (BUN, creatinine, urinalysis) in patients with pre-existing renal impairment
Signs of hypersensitivity or injection site reactions

과용량

Cephalosporin overdoses are unlikely to cause significant problems. However, **very high doses given rapidly IV could potentially cause seizures** or neurotoxicity. Treatment for overdose should be supportive and symptomatic.

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