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Hemodialysis of cefazolin.

Seven patients received 0.5 g of cefazolin intravenously at the beginning of hemodialysis. The concentration of cefazolin was determined by bioassay in plasma and dialysate during and after dialysis. Ten studies were performed. The half-life of cefazolin was 6.5 hr in arterial plasma and 6.54 hr in venous plasma. The mean cumulative removal was 138.5 mg. Concentration in venous plasma prior to subsequent dialysis was 8-10 [tg/ml. Throughout dialysis concentrations in plasma exceeded the minimal inhibitory concentration of cefazolin for a variety of bacterial pathogens. The persistence of cefazolin during dialysis permits the maintenance of inhibitory concentrations in plasma during and after dialysis with a single iv injection of cefazolin at the beginning of dialysis. Cefazolin is a new 7-amino-cephalosporanic acid derivative that has two potential advantages when compared with currently available antibiotics derived from cephalosporanic acid. The concentrations achieved in the blood are higher and last longer than those of other cephalosporins [1, 2]. Cefazolin may be less nephrotoxic than cephaloridine [3]. Infections of the skin, urinary tract, and respiratory tract have been successfully treated with cefazolin [4-10]. The clinical setting in which the cephalosporins are used often includes therapy of patients with severely compromised renal function, many of whom may be managed by extracorporeal dialysis. The effect of hemodialysis on the concentration of cefazolin in the blood must be known in order to rationally manage cefazolin therapy of the patients undergoing dialysis. This study describes the effect of hemodialysis on cefazolin administered at the beginning of dialysis.