Introduction
Zolibac is an antibiotic medicine used to treat bacterial infections in your body. It is effective in infections of the lungs (eg. pneumonia), ear, urinary tract, skin and soft tissues, bones and joints, blood, and heart. It is also used to prevent infections during surgery.
Zolibac fights and stops the growth of bacteria. This helps to improve your symptoms and cure the underlying infection. It is given as a slow drip (intravenous infusion) under the supervision of a healthcare professional. Your doctor will decide the correct dose for you. You should use this medicine regularly at evenly spaced intervals as per the schedule prescribed by your doctor. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping the medicine too early may lead to the infection returning or worsening.
The most common side effects of this medicine include rash, nausea, indigestion, and diarrhea. Some people may develop temporary redness or pain at the site of injection. These side effects are usually mild but let your doctor know if they bother you or last more than a few days.
Before using it, you should tell your doctor if you are allergic to any antibiotics, and if you have any liver or kidney problems. You should also let your doctor know all other medicines you are taking as they may affect, or be affected by this medicine. Pregnant and breastfeeding mothers should consult their doctor before using it.
Side effects of Zolibac
Common
- Rash
- Injection site reactions (pain, swelling, redness)
- Allergic reaction
- Nausea
- Indigestion
- Diarrhea
How to use Zolibac
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Zolibac works
Zolibac is an antibiotic. It kills bacteria by preventing them from forming the bacterial protective covering (cell wall) which is needed for them to survive.
What if you forget to take Zolibac?
If you miss a dose of Zolibac, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Infections With Gram-Positive Cocci, Mild-to-Moderate Cholecystitis, Uncomplicated Urinary Tract Infection, Prophylaxis against surgical infection, Endocarditis, Community-Acquired Pneumonia
Administration
IV Preparation
Reconstitute 500 mg or 1 g with 2 mL or 2.5 mL SWI, respectively, to provide solutions containing approximately 225 or 330 mg/mL
IV push: Further dilute in approximately 5 mL of SWI or according to manufacturer's directions
Infusion: Dilute reconstituted 500 mg or 1 g solution in 50-100 mL NS or D5W
IM Preparation
Reconstitute 500 mg or 1 g with 2 mL or 2.5 mL SWI, respectively, to provide solutions containing approximately 225 or 330 mg/mL
IV Administration
IV push
Administer directly into vein, and infuse over 3-5 minutes or slowly into tubing of compatible IV infusion solution
IM Administration
Inject deep into large muscle mass
Adult Dose
Parenteral
Susceptible infections
Adult: Mild: 0.25-0.5 g 8 hrly.
Moderate to severe: 0.5-1 g 6-8 hrly.
Severe, life-threatening: 1-1.5 g 6 hrly. Max: 12 g daily.
All doses to be given by deep IM inj, slow IV inj over 3-5 min, or intermittent or continuous IV infusion.
Mild Infections With Gram-Positive Cocci
250-500 mg IV q8hr
Mild-to-Moderate Cholecystitis
1-2 g IV q8hr for 4-7 days
Uncomplicated Urinary Tract Infection
1 g IV q12hr
Preparation for Surgery
Prophylaxis against infection
Preoperatively: 1-2 g IV/IM ?60 minutes before procedure (may be repeated in 2-5 hours intraoperatively)
Postoperatively: 0.5-1 g IV q6-8hr for 24 hours
Surgical infection
Cardiac procedures, hysterectomy, oral or pharyngeal procedures, craniotomy, joint replacement, thoracic procedures, arterial procedures, amputation, traumatic wounds; high-risk esophageal, gastroduodenal, or biliary tract procedures: 1-2 g IV
Colorectal procedures: 1-2 g IV plus metronidazole 0.5 g IV
High-risk cesarean section, 2nd trimester abortion: 1 g IV
Ophthalmic procedures: 100 mg subconjunctivally
Endocarditis
1 g IV/IM 30-60 minutes before procedure
American Heart Association (AHA) guidelines: Endocarditis prophylaxis recommended only for high-risk patients
Child Dose
Parenteral
Susceptible infections
Child: >1 yr 25-50 mg/kg daily in 3 or 4 divided doses to be given by deep IM inj, slow IV inj over 3-5 min, or intermittent or continuous IV infusion.
Max: 100 mg/kg daily in divided doses for severe infections.
Infections With Gram-Positive Cocci
Neonates (<28 days)
<7 days: 40 mg/kg/day IV/IM divided q12hr
>7 days, <2 kg: 40 mg/kg/day IV/IM divided q12hr
>7 days, >2 kg: 60 mg/kg/day IV/IM divided q8hr
Infants & children
25-100 mg/kg/day IV/IM divided q6-8hr; not to exceed 6 g/day
Endocarditis
Prophylaxis
50 mg/kg IV/IM ?30-60 minutes before procedure; not to exceed 1 g
AHA guidelines: Endocarditis prophylaxis recommended only for high-risk patients
Community-Acquired Pneumonia
>3 months and children: 150 mg/kg/day IV/IM divided q8hr (moderate to severe infections, methicillin susceptible S.Aureus preferred
Renal Dose
Renal impairment:
CrCl (ml/min) Dosage Recommendation
<10 Half the usual dose 18-24 hrly.
11-34 Half the usual dose 12 hrly.
35-54 Usual dose at intervals of at least 8 hr.
Contraindication
Hypersensitivity to cephalosporins.
Mode of Action
Cefazolin binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Precaution
Patient w/ history of hypersensitivity to penicillins, GI disease particularly colitis, seizure disorder. Renal impairment. Pregnancy and lactation. Monitoring Parameters Monitor prothrombin time; renal, hepatic and haematological function; monitor for signs of anaphylaxis during 1st dose.
Lactation: Drug excreted in breast milk; use with caution (American Academy of Pediatrics committee states that drug is compatible with nursing)
Side Effect
Diarrhoea, oral candidiasis, vomiting, nausea, stomach cramps, anorexia; eosinophilia, itching, drug fever, skin rash, Stevens-Johnson syndrome; neutropenia, leucopenia, thrombocytopenia, thrombocythemia; transient elevation in SGOT, SGPT and alkaline phosphatase levels; hepatitis; increased BUN and creatinine levels, renal failure; phlebitis, induration; genital and anal pruritus (e.g. vulvar pruritus, genital moniliasis, vaginitis).
Potentially Fatal: Anaphylaxis, pseudomembranous colitis.
Pregnancy Category Note
Pregnancy category: B
Lactation: Drug excreted in breast milk; use with caution (American Academy of Pediatrics committee states that drug is compatible with nursing)
Interaction
May enhance the anticoagulant effect of vit K antagonists (e.g. warfarin). May diminish the therapeutic effect of Na picosulfate, BCG and typhoid vaccine. May decrease the protein binding of fosphenytoin and phenytoin. Probenecid may decrease renal tubular secretion of cefazolin, resulting in increased and prolonged blood levels. May increase the nephrotoxic effects of aminoglycosides.