Investigation of Perioperative Antimicrobial Cefazolin in Excess of 100 mg/kg/day in Pediatric Patients Undergoing Spinal Fusion Surgery

The maximum cefazolin dosage for pediatric patients is 100 mg/kg/day according to the medical package insert. When cefazolin is used on surgical site infection (SSI) for prophylaxis, clinical practice guidelines state that the cefazolin dosage for antimicrobial prophylaxis is 30 mg/kg/time. However, the dosage of cefazolin exceeds 100 mg/kg/day from the beginning of administration to 24 hours later due to the long operation time during which cefazolin administration is repeated every 4 hours. The effects of exceeding cefazolin doses in pediatric patients have not been reported. We investigated the relationship between the cefazolin dosage and organ derangement in pediatric patients undergoing spinal fusion.