Cefazolin
Renal

Renal

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

1 - 2 g IV q24h

Continuous Renal Replacement Therapy (CRRT)

2 g IV q12h