Non-Dialysis
CrCl greater than 50 mL/min
No renal adjustment required
CrCl 30 - 50 mL/min
2 g IV q12h
- Outpatient Cellulitis: 2 g IV q12h (without probenecid) OR 2 g IV q24h with probenecid 1 g PO 30 min before each cefazolin dose
CrCl 10 - 30 mL/min
2 g IV q12h
CrCl less than 10 mL/min
2 g IV q24h
Intermittent Dialysis
2 g IV qHD
- Give dose after dialysis on HD days; none on non-HD days
- Consider giving 3 g if next HD is scheduled in more than 48 hours (e.g. on Friday if on M-W-F HD schedule)
- 2 g IV q24h after dialysis is safe and may be used for severe, invasive infections
Peritoneal Dialysis
Continuous Renal Replacement Therapy (CRRT)