頭孢唑林
Cefazolin
Cefazolin sodium
別名: Ancef · Kefzol · Zolicef · 46083 · cefazolinum natricum · cephazolin sodium · SKF-41558
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Susceptible infections (extra-label)
須由已驗證獸醫確認
- q6-8h
NA
必須一併考量的臨床脈絡 (4)
- 1. If injecting IM, the drug must be injected into a large muscle mass.
- 2. IV injections should be given slowly (ie, over 3 to 5 minutes).
- Cefazolin sodium powder for injection and solutions for injection should be protected from light. The powder for injection should be stored at room temperature (20°C-25°C [68°F-77°F]) but may be exposed to 15°C to 30°C (59°F-86°F) temperatures; temperatures above 40°C (104°F) should be avoided. The frozen solution for injection should be stored at temperatures no higher than -20°C (-4°F).
- After reconstitution, the solution will be stable for 24 hours if kept at room temperature or for 10 days if refrigerated (5°C [41°F]). If, after reconstitution, the solution is immediately frozen in the original container, the preparation will be stable for at least 12 weeks when stored at -20°C (-4°F).
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
頭孢唑林是一種主要透過注射給藥的第一代頭孢菌素類抗生素，在獸醫學中被廣泛使用。雖然它未獲 FDA 批准專門用於獸醫物種，但它是臨床上用於外科手術預防性投藥（特別是骨科與軟組織手術）以及治療全身性感染（包括敗血症）的主力藥物。
臨床重點：
- 抗菌譜： 對大多數革蘭氏陽性病原體（如中間型葡萄球菌、金黃色葡萄球菌、鏈球菌屬）具有極佳的覆蓋率，但對革蘭氏陰性病原體的覆蓋率則不穩定或較差。它對大多數厭氧菌非常有效，但脆弱擬桿菌（Bacteroides fragilis）除外。
- 藥效學： 它是一種時間依賴型殺菌抗生素。其療效取決於在給藥間隔的大部分時間內，將感染部位的藥物濃度維持在最低抑菌濃度（MIC）以上。目前越來越多地採用恆速靜脈輸注（CRI）方案來優化此參數。
- 給藥方式： 由於口服吸收不佳，必須透過腸胃外途徑（IV、IM、SC、IO）給藥。靜脈注射應在 3-5 分鐘內緩慢進行，以減少不良反應。
作用機轉
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).
安全性與警告
禁忌症
- Patients with a known history of hypersensitivity to cephalosporins
不良反應
- 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)
注意事項
Use cautiously in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., penicillins, carbapenems) due to the potential for cross-reactivity. Dosage adjustments may be necessary in patients with severe renal failure, as the drug is primarily excreted unchanged by the kidneys. Safe use during pregnancy has not been firmly established (FDA Category B), though teratogenic effects have not been documented; use only when benefits outweigh risks. Cefazolin is distributed into milk and may alter neonatal gut flora in nursing dams.
藥物交互作用
Potential for additive nephrotoxicity; use concurrently with caution.
Potential for additive nephrotoxicity; use concurrently with caution.
Competitively blocks the renal tubular secretion of cefazolin, thereby increasing serum levels and prolonging the elimination half-life.
監測
- 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
藥物動力學
半衰期
吸收
Not appreciably absorbed after oral administration; must be given parenterally. In dogs, peak levels occur approximately 30 minutes after IM administration.
分佈
Apparent volume of distribution at steady state: 700 mL/kg (dogs), 190 mL/kg (horses), 165 mL/kg (calves). Plasma protein binding is approximately 16-28% in dogs and 4-8% in horses. Crosses the placenta and is distributed into milk.
代謝
Minimal to no hepatic metabolism.
排除
Excreted unchanged by the kidneys into the urine. In dogs, approximately 64% of clearance is attributed to renal tubular secretion. Elimination half-lives may be significantly prolonged in patients with severely diminished renal function.
過量
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.
可用產品
劑型
- Powder for injection
- Solution for injection (IV infusion)
人用標示
- Cefazolin Sodium Powder for Injection: 500 mg, 1 g, 5 g, 10 g, & 20 g in vials & piggyback vials
- Cefazolin Sodium for Injection (IV infusion): 1 g in 50 mL plastic containers or duplex bags
各地核准狀態
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儲存與穩定性
Protect powder and solutions from light. Store powder at room temperature (15-30°C); avoid temperatures above 40°C. After reconstitution, the solution is stable for 24 hours at room temperature, 96 hours if refrigerated, or at least 12 weeks if immediately frozen at -20°C.
飼主須知
頭孢唑林是一種注射型抗生素，通常由您的獸醫師在診所或醫院環境中給予，最常用於預防手術期間的感染或治療嚴重的全身性感染。
重要提示： 由於此藥物是透過注射（靜脈或肌肉注射）給予，您不需要在家中自行餵藥。
- 過敏反應： 雖然罕見，但如果您的寵物回家後出現過敏反應的跡象（如面部腫脹、尋麻疹或呼吸困難），請立即聯繫您的獸醫師。
- 注射部位： 您的寵物可能會在注射部位感到輕微的痠痛。如果您注意到嚴重的腫脹、發紅或疼痛，請告知您的獸醫團隊。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。