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Cefazolin + metronidazole is a combination of two antibiotics commonly used for surgical prophylaxis, especially in clean-contaminated procedures such as abdominal, gynecological, and obstetric surgeries. Cefazolin is a first-generation cephalosporin that acts by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins, leading to cell lysis. Metronidazole is a nitroimidazole antibiotic that acts as a prodrug; it inhibits nucleic acid synthesis in anaerobic bacteria and protozoa by forming reactive nitroso radicals that disrupt microbial DNA. The combination provides broad-spectrum coverage against both aerobic (mainly Gram-positive) and anaerobic organisms. Clinical studies have shown this regimen reduces postoperative infection rates and hospital stays compared to cefazolin alone[1][2][5].
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