Clinical Tools & Calculators

Cefazolin – Pre-op Neurosurgical Prophylaxis

For educational use. This tool is intended for reference and education. All care decisions require a direct clinical assessment of the patient and independent verification of doses and values by the treating team. The calculation runs locally in your browser, no patient data is sent to any server.

Cefazolin – Pre-op Neurosurgical Prophylaxis

The standard pre-operative prophylactic antibiotic for craniotomy, shunt insertion, and most clean neurosurgical operations. Administered within 60 minutes of the incision and re-dosed every 4 hours intraoperatively.

600
mg IV pre-incision
Re-dose every 4 hours intraop
Clinical notes:
  • Dose: 30 mg/kg (max 2 g; 3 g if weight > 120 kg).
  • Timing: within 60 minutes of incision.
  • For severe penicillin allergy or MRSA risk: vancomycin 15 mg/kg (max 2 g) within 120 min of incision.
  • Do not extend prophylaxis beyond skin closure in clean cases.

Reference: Bratzler DW, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm 2013;70(3):195–283. PMID 23327981 · doi:10.2146/ajhp120568

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