Cefazolin
| Usage | Recommendation | Comments |
|---|---|---|
| Treatment | Insufficient data | PK considerably altered in obesity. For treatment of active infection, consider a higher dose and/or continuous infusion in patients ≥120 kg with less susceptible gram-negative infection, critically ill, or immunocompromised (IJAA 2023;61:107651). |
| Surgical prophylaxis | 3 gm x1 dose if ≥120 kg | Joint guideline recommendation is 3 gm x1 if ≥120 kg, 2 gm x1 if <120 kg (Am J Health Syst Pharm 2013;70:195). However, in a recent systematic review, 3/3 outcome studies and 9/15 PK studies found the 3 gm dose in patients ≥120 kg to be unnecessary (Obes Surg 2022;32:3138). Similar finding (i.e., 2 gm adequate in obesity) in a recent model-based analysis (Br J Anaesth 2025;134:1041). |