Once-daily intravenous cefazolin plus oral probenecid is equivalent to once-daily intravenous ceftriaxone plus oral placebo for the treatment of moderate-to-severe cellulitis in adults

Clin Infect Dis. 2002 Jun 1;34(11):1440-8. doi: 10.1086/340056. Epub 2002 May 7.


A once-daily regimen of cefazolin (2 g intravenously [iv]) plus probenecid (1 g by mouth) was compared with a once-daily regimen of ceftriaxone (1 g iv) plus oral placebo in a randomized, double-blind equivalence trial of home-based therapy for moderate-to-severe cellulitis in adults. For the assessable recipients of cefazolin-probenecid (n=59) and ceftriaxone-placebo (n=57), clinical cure occurred at the end of treatment in 86% and 96% (P=.11), respectively, and was maintained at 1 month of follow-up in 96% and 91% (P=.55), respectively. The mean number of treatment doses (+/-standard deviation) given was similar in the 2 treatment arms (6.97+/-2.6 for cefazolin-probenecid and 6.12+/-2.1 for ceftriaxone-placebo; P=.06). The median antibiotic trough concentrations were 2.35 microgram/mL for cefazolin and 15.45 microgram/mL for ceftriaxone. Patients in the 2 treatment arms were similar with regard to overall rates of adverse reaction (P=.15), but nausea was more common among those in the cefazolin-probenecid arm (P=.048). The once-daily regimen of cefazolin-probenecid is a cheap, practical, and effective treatment option for moderate-to-severe cellulitis, and it avoids the need to use third-generation cephalosporins in most patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cefazolin / adverse effects
  • Cefazolin / therapeutic use*
  • Ceftriaxone / adverse effects
  • Ceftriaxone / therapeutic use*
  • Cellulitis / drug therapy*
  • Cephalosporins / adverse effects
  • Cephalosporins / therapeutic use
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Placebos / therapeutic use*
  • Probenecid / adverse effects
  • Probenecid / therapeutic use*
  • Uricosuric Agents / adverse effects
  • Uricosuric Agents / therapeutic use


  • Cephalosporins
  • Placebos
  • Uricosuric Agents
  • Ceftriaxone
  • Cefazolin
  • Probenecid