کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8738462 | 1591727 | 2018 | 26 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Prophylactic cefazolin concentrations in morbidly obese patients undergoing sleeve gastrectomy: do we achieve targets?
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کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری
ایمنی شناسی و میکروب شناسی
میکروبیولوژی و بیوتکنولوژی کاربردی
پیش نمایش صفحه اول مقاله
![عکس صفحه اول مقاله: Prophylactic cefazolin concentrations in morbidly obese patients undergoing sleeve gastrectomy: do we achieve targets? Prophylactic cefazolin concentrations in morbidly obese patients undergoing sleeve gastrectomy: do we achieve targets?](/preview/png/8738462.png)
چکیده انگلیسی
Morbid obesity is known to increase the risk of surgical site infections. Optimal concentrations of prophylactic antibacterial drugs are required. Using Monte Carlo simulations, the aim of this work was to build a population pharmacokinetics model for a morbidly obese population to assess a 4000-mg dose of cefazolin recommended by the guidelines and to propose new administration schemes. One hundred and seventeen morbidly obese patients (mean body mass index, 46.95 kg/m2) received 4000 mg of cefazolin intravenously before sleeve gastrectomy. Using population pharmacokinetics modelling and Monte Carlo simulations, probabilities of target attainment (PTAs) (subcutaneous tissue concentration of cefazolin above the minimum inhibitory concentration (MIC) throughout the surgical procedure was targeted) were determined. For Staphylococcus spp. and Streptococcus spp., which are the most frequent species isolated from post-surgical infections in bariatric surgery (MIC usually â¤2 mg/L), PTA remains greater than 0.9 until 2 h after administration of 4000 mg of cefazolin. For MIC up to 4 mg/L, efficient prophylaxis was checked until 1 h after the initial administration. A 3000-mg regimen followed by a continuous infusion (1000 mg/h) achieves these two targets until 4 h after the loading dose. A 2000-mg and a 3000-mg regimen do not achieve sufficient concentrations. According to the duration of surgery and MIC values, an initial administration of 4000 mg should be sufficient, but for extended surgeries continuous infusion can be considered.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Antimicrobial Agents - Volume 52, Issue 1, July 2018, Pages 28-34
Journal: International Journal of Antimicrobial Agents - Volume 52, Issue 1, July 2018, Pages 28-34
نویسندگان
Matthieu Grégoire, Romain Dumont, Ludovic Ronchi, Jean-Baptiste Woillard, Vincent Atthar, Eric Letessier, Raphaël Cinotti, Antoine Roquilly, Guillaume Deslandes, Pascale Jolliet, Karim Asehnoune, Eric Dailly,