Cefazolin
| Evidence Level: L5 | Predicted Indications: 8 |
Table of Contents
- Cefazolin
- Pharmacist Assessment Report
- Cefazolin: first-generation cephalosporin (bacterial cell wall synthesis inhibitor) → infectious otitis media
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Clinical Trial Evidence
- Literature Evidence
- Canada Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Cefazolin: first-generation cephalosporin (bacterial cell wall synthesis inhibitor) → infectious otitis media
One-Sentence Summary
Cefazolin is a first-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis. The TxGNN model predicts it may be useful for infectious otitis media, but no clinical trials and only 2 publications (a case report and an unrelated review) were retrieved, and neither directly studies cefazolin as a treatment for this disease.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | infectious otitis media |
| TxGNN Prediction Score | 0.9944 |
| Evidence Level | L5 |
| Canada Market Status | Marketed (marketed DINs: 15 of 16; cancelled: 1) |
| Number of DINs | 16 (marketed: 15) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism-of-action data is not available in the data compiled for this report. Cefazolin is known to be a first-generation cephalosporin that binds penicillin-binding proteins and blocks bacterial cell wall synthesis. It is active against streptococci and methicillin-susceptible Staphylococcus aureus, which can cause otitis media.
The mechanistic link is only partial. Cefazolin has limited activity against the most common otitis pathogens, Haemophilus influenzae and Moraxella catarrhalis. This weakens the rationale compared with agents designed to cover those organisms.
The retrieved literature does not close this gap. One paper is a 2025 pediatric case report of Gradenigo syndrome (a complication of otitis media) treated with a ceftazidime–cefazolin empiric combination. The other is a 1986 review of Stevens-Johnson syndrome management that mentions otitis media only incidentally. Neither studies cefazolin for infectious otitis media itself, so the evidence level is L5 (model prediction only).
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 39567876 | 2025 | Case report | Annals of Otology, Rhinology, and Laryngology | Pediatric Gradenigo syndrome (petrous apicitis after acute otitis media) managed with empiric ceftazidime–cefazolin; a complicated condition, not uncomplicated otitis media, and a combination regimen |
| 3742953 | 1986 | Review | Clinical Pharmacy | Review of Stevens-Johnson syndrome management; otitis media appears only as part of one patient’s history, so it is not relevant to efficacy |
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 02308959 | CEFAZOLIN FOR INJECTION USP | Not recorded | Not recorded |
| 02308967 | CEFAZOLIN FOR INJECTION USP | Not recorded | Not recorded |
| 02108119 | CEFAZOLIN FOR INJECTION | Not recorded | Not recorded |
| 02524791 | CEFAZOLIN SODIUM FOR INJECTION BP | Not recorded | Not recorded |
| 02437112 | CEFAZOLIN FOR INJECTION | Not recorded | Not recorded |
The approved indication text is not recorded in the local data.
Safety Considerations
- Drug Interactions: The interaction check completed with 100 records. The first entries were rated Moderate for the aminoglycosides kanamycin, neomycin and streptomycin, and for picosulfuric acid. Other listed interactions (for example calcitriol, epinephrine, amphotericin B, mannitol, acetylsalicylic acid, amoxicillin, metformin and omeprazole) have an unknown severity level.
Please refer to the package insert for warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is high, but there are no registered trials and no published study directly evaluating cefazolin for infectious otitis media. Cefazolin’s spectrum also misses key otitis pathogens, so the clinical case is weak at this stage.
To proceed, the following is needed:
- Direct clinical or microbiological evidence of cefazolin efficacy in infectious otitis media, including coverage of H. influenzae and M. catarrhalis
- Comparison against guideline-recommended agents for otitis media
- Package insert warnings and contraindications from Health Canada
- Mechanism-of-action data from DrugBank
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.