Cefazolin Dosing for Central Nervous System Infections
Recommended Dosing Regimen
- The American Heart Association recommends cefazolin at 100 mg/kg/day IV divided every 8 hours for staphylococcal infections that may involve the CNS 1, 2, 3
- Standard dosing for CNS infections: 100 mg/kg/day IV divided every 8 hours (maximum 12 g daily) 1, 2, 4
- Pediatric dosing: 100 mg/kg/day IV divided every 8 hours 1, 3
Alternative Agents for CNS Infections
- For MRSA CNS infections: Vancomycin 15-20 mg/kg/dose IV every 8-12 hours (adults) or 15 mg/kg/dose IV every 6 hours (pediatrics) 5, 6, 7
- Some experts recommend adding rifampin 600 mg daily or 300-450 mg twice daily to vancomycin for CNS infections 5, 6, 8
- Alternative agents include: Linezolid 600 mg PO/IV twice daily (adults) or 10 mg/kg/dose PO/IV every 8 hours (pediatrics) 5, 6, 7
- Alternative agents include: TMP-SMX 5 mg/kg/dose IV every 8-12 hours 5, 6, 7
Monitoring Parameters
- For patients receiving high-dose cefazolin for CNS infections, monitor clinical response (temperature, white blood cell count, neurological status) 9
Duration of Therapy
- Meningitis: 2 weeks of IV therapy 8
- Brain abscess, subdural empyema, spinal epidural abscess: 4-6 weeks of IV therapy 6, 8
- Septic thrombosis of cavernous or dural venous sinus: 4-6 weeks of IV therapy 6, 7