Your Patients Can't Find Cefazolin — Here's How You Can Help

As a provider, you've likely fielded calls from patients who can't fill their Cefazolin prescriptions. Maybe they've been discharged with a plan for home IV antibiotics and their infusion pharmacy says it's on backorder. Maybe they're calling back because their surgery has been delayed due to a prophylaxis drug shortage.

These conversations are frustrating for everyone — but you're in a unique position to help. This guide walks through what's happening with Cefazolin availability, why patients are struggling, and five concrete steps you can take to improve their access.

Current Cefazolin Availability in 2026

Cefazolin supply in 2026 is best described as intermittently constrained. The most important points:

• Powder vials (500 mg, 1 g, 2 g) are more reliably available than premixed solutions
• Premixed frozen bags have been more frequently affected by supply disruptions
• Multiple manufacturers (Hikma, Sandoz, Sagent, WG Critical Care, Baxter) produce Cefazolin, providing some supply diversification
• Availability varies by region, distributor, and pharmacy type — hospital pharmacies with GPO contracts generally have better access

For historical context and more details, see our provider-focused shortage update.

Why Patients Can't Find Cefazolin

Your patients face several barriers that you may not encounter in your institutional practice:

They're in the Retail/Home Infusion Supply Chain

Hospital pharmacies often have priority access through GPO contracts and can source from multiple distributors. Patients transitioning to home infusion may find that their home infusion pharmacy has different — and sometimes more limited — supply channels.

They Don't Know Where to Look

Most patients have no idea that Cefazolin availability varies by pharmacy. They call one pharmacy, hear "out of stock," and assume it's unavailable everywhere. They may not know about specialty infusion pharmacies, independent pharmacies, or availability-tracking tools.

Communication Gaps at Discharge

If a patient is discharged with a plan for home IV Cefazolin but the home infusion pharmacy can't source it, the patient may face days of treatment delays while the pharmacy, prescriber, and insurance company sort out alternatives.

Cost Barriers

While Cefazolin itself is relatively inexpensive ($5 to $30 per vial), the total cost of home infusion services — including supplies, equipment, and nursing — can be significant, especially for uninsured or underinsured patients. For cost-saving strategies, see How to Help Patients Save Money on Cefazolin.

What Providers Can Do: 5 Practical Steps

Step 1: Verify Availability Before Prescribing for Outpatient Use

Before discharging a patient on home IV Cefazolin, coordinate with the home infusion pharmacy to confirm they can supply it. A brief phone call or electronic referral check can prevent the patient from arriving home without their antibiotic.

Use Medfinder for Providers to quickly check real-time availability across pharmacies and suppliers in your patient's area.

Step 2: Have Alternative Protocols Ready

Don't wait until discharge day to discover Cefazolin is unavailable. Prepare a decision tree for common scenarios:

• Surgical prophylaxis: Ceftriaxone 2 g IV or Cefuroxime 1.5 g IV as first-line substitutes
• MSSA infections (OPAT): Ceftriaxone (once-daily, easier for home infusion) or oral step-down to Cephalexin when appropriate
• Skin/soft tissue infections: Consider oral Cephalexin 500 mg q6h for mild-moderate cases that don't require IV therapy
• Beta-lactam allergic patients: Clindamycin IV or oral, depending on infection severity

For a complete comparison, refer to Alternatives to Cefazolin.

Step 3: Recommend Medfinder to Patients

Give patients a concrete tool they can use. Direct them to medfinder.com to check real-time Cefazolin availability in their area. This empowers patients to be proactive rather than making repeated phone calls to your office when their pharmacy says "out of stock."

Consider including Medfinder in your discharge instructions or patient handouts for medications prone to shortage.

Step 4: Leverage Your Institutional Pharmacy

Your hospital pharmacy team has resources and relationships that patients don't:

• Ask your hospital pharmacist to help locate Cefazolin through institutional channels
• Some hospitals can dispense a "bridge supply" from their pharmacy to cover patients during the transition to home infusion
• Infectious disease pharmacists often have the most up-to-date information on antibiotic availability and can recommend evidence-based alternatives

Step 5: Consider Early Oral Step-Down

For appropriate patients, transitioning from IV Cefazolin to oral Cephalexin (Keflex) earlier in the treatment course can:

• Reduce dependence on Cefazolin supply
• Lower treatment costs for patients
• Improve patient quality of life (no IV line, no infusion pump)
• Reduce nursing visit requirements

The OPAT literature increasingly supports early oral step-down for many infections traditionally treated with prolonged IV courses. Evaluate each patient individually, but don't default to "maximum IV duration" when oral therapy may be equally effective.

Alternative Antibiotics at a Glance

Here's a quick reference for the most common Cefazolin alternatives:

• Ceftriaxone (Rocephin): Third-generation cephalosporin, IV/IM, once-daily dosing. Broader spectrum than needed for most Cefazolin indications but widely available and convenient for OPAT.
• Cephalexin (Keflex): First-generation cephalosporin, oral, q6h dosing. Excellent for step-down therapy. Very inexpensive ($4 to $15 for a course).
• Nafcillin: Anti-staphylococcal penicillin, IV, q4-6h. Traditional alternative for MSSA but more phlebitis and hepatotoxicity risk.
• Clindamycin: Lincosamide, IV or oral. Non-beta-lactam option for allergic patients. Higher C. diff risk.

Workflow Tips

• Flag shortage-prone drugs in your EHR: Work with your IT team to add alerts when prescribing medications on the shortage list
• Create discharge order sets with alternatives: Build order sets that include Cefazolin and its alternatives, with clear criteria for when to use each
• Establish a pharmacy liaison: Designate someone (pharmacist, nurse coordinator, or case manager) to verify medication availability before discharge
• Keep patient-facing resources handy: Bookmark How to Find Cefazolin in Stock and How to Save Money on Cefazolin for easy sharing with patients

Final Thoughts

The Cefazolin shortage puts an additional burden on providers who are already stretched thin. But small, proactive steps — verifying availability before discharge, having alternative protocols ready, and pointing patients toward tools like Medfinder — can make a meaningful difference in your patients' experience and outcomes.

For the complete provider briefing on the Cefazolin shortage, including timeline, clinical implications, and policy outlook, see Cefazolin Shortage: What Providers Need to Know in 2026.