Comparative total and unbound pharmacokinetics of cefazolin administered by bolus versus continuous infusion in patients undergoing major surgery: a randomized controlled trial

British Journal of Anaesthesia
B I NaikJason A Roberts

Abstract

Perioperative administration of cefazolin reduces the incidence of perioperative infections. Intraoperative re-dosing of cefazolin is commonly given between 2 and 5 h after the initial dose. This study was undertaken to determine whether intraoperative continuous infusions of cefazolin achieve better probability of target attainment (PTA) and fractional target attainment (FTA) than intermittent dosing. Patients undergoing major surgery received cefazolin 2 g before surgical incision. They were subsequently randomized to receive either an intermittent bolus (2 g every 4 h) or continuous infusion (500 mg h -1 ) of cefazolin until skin closure. Blood samples were analysed for total and unbound cefazolin concentrations using a validated chromatographic method. Population pharmacokinetic modelling was performed using Pmetrics ® software. Calculations of PTA and FTA were performed for common pathogens. Ten patients were enrolled in each arm. A two-compartment linear model best described the time course of the total plasma cefazolin concentrations. The covariates that improved the model were body weight and creatinine clearance. Protein binding varied with time [mean (range) 69 (44-80)%] with a fixed 21% unbound value of cefazolin use...Continue Reading

References

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Apr 20, 2007·International Journal of Antimicrobial Agents·Jason A RobertsJeffrey Lipman
Jul 11, 2008·Current Opinion in Critical Care·Jason A RobertsJordi Rello
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Jul 4, 2012·Annals of Intensive Care·Bruno Van HerendaelMargareta Ieven
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Mar 7, 2013·Surgical Infections·Dale W BratzlerUNKNOWN Society for Healthcare Epidemiology of America (SHEA)
Mar 15, 2016·American Journal of Respiratory and Critical Care Medicine·Jason A RobertsJeffrey Lipman
May 27, 2016·Microbiology Spectrum·Alexandra E Paharik, Alexander R Horswill
Jul 13, 2016·The Journal of Antimicrobial Chemotherapy·S A ZelenitskyG G Zhanel

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Citations

Jul 3, 2018·Paediatric Anaesthesia·James MorseBrian J Anderson
Jul 17, 2019·Antimicrobial Agents and Chemotherapy·Ronan BellouardMatthieu Grégoire
Dec 13, 2019·Advances in Wound Care·Thomas Charles LangChristopher John Jackson
Jan 28, 2021·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Adriano Carneiro da CostaÁlvaro A B Ferraz

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