Antibiotic prophylaxis with high-dose cefoxitin in bariatric surgery: an observational prospective single center study.
Journal
Antimicrobial agents and chemotherapy
ISSN: 1098-6596
Titre abrégé: Antimicrob Agents Chemother
Pays: United States
ID NLM: 0315061
Informations de publication
Date de publication:
09 09 2019
09 09 2019
Historique:
medline:
9
10
2019
entrez:
9
10
2019
pubmed:
9
10
2019
Statut:
ppublish
Résumé
The optimal dose of cefoxitin for antibiotic prophylaxis in obese patients remains uncertain. We evaluated the adequacy of a 4-gram dosing regimen of cefoxitin against the most frequent pathogens that infect patients undergoing bariatric surgery. This observational prospective study included obese patients who required bariatric surgery and a 4-gram dose of cefoxitin as an antibiotic prophylaxis. Serum concentrations were measured during surgery (incision, wound closure and in case of reinjection). The pharmacokinetic/pharmacodynamic (PK/PD) target was to obtain free cefoxitin concentrations above 4× MIC, from incision to wound closure (100% ƒT Two hundred patients were included. The mean age of the patients was 46 (±12) years-old, and the mean BMI was 45.8 (±6.9) kg/m In obese patients undergoing bariatric surgery, a regimen of 4 grams of cefoxitin led to an inadequate coverage for most common pathogens. A longer surgery duration and BMI over 50 kg/m
Sections du résumé
BACKGROUND
BACKGROUND
The optimal dose of cefoxitin for antibiotic prophylaxis in obese patients remains uncertain. We evaluated the adequacy of a 4-gram dosing regimen of cefoxitin against the most frequent pathogens that infect patients undergoing bariatric surgery.
METHODS
METHODS
This observational prospective study included obese patients who required bariatric surgery and a 4-gram dose of cefoxitin as an antibiotic prophylaxis. Serum concentrations were measured during surgery (incision, wound closure and in case of reinjection). The pharmacokinetic/pharmacodynamic (PK/PD) target was to obtain free cefoxitin concentrations above 4× MIC, from incision to wound closure (100% ƒT
RESULTS
RESULTS
Two hundred patients were included. The mean age of the patients was 46 (±12) years-old, and the mean BMI was 45.8 (±6.9) kg/m
CONCLUSIONS
CONCLUSIONS
In obese patients undergoing bariatric surgery, a regimen of 4 grams of cefoxitin led to an inadequate coverage for most common pathogens. A longer surgery duration and BMI over 50 kg/m
Identifiants
pubmed: 31591127
pii: AAC.01613-19
doi: 10.1128/AAC.01613-19
pmc: PMC6879239
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2019 American Society for Microbiology.
Références
Am J Infect Control. 1992 Oct;20(5):271-4
pubmed: 1332552
Antimicrob Agents Chemother. 2013 Dec;57(12):6165-70
pubmed: 24080664
AMA Arch Surg. 1955 Jul;71(1):2-6
pubmed: 14387367
Surg Infect (Larchmt). 2006 Oct;7(5):473-80
pubmed: 17083313
Curr Opin Infect Dis. 2012 Dec;25(6):634-49
pubmed: 23041773
Expert Opin Drug Saf. 2018 May;17(5):499-508
pubmed: 29633867
Drugs. 1979 Jan;17(1):1-37
pubmed: 369806
Am J Infect Control. 2012 Nov;40(9):815-9
pubmed: 22325729
Anesth Analg. 2011 Oct;113(4):730-7
pubmed: 21642605
Antimicrob Agents Chemother. 2016 Sep 23;60(10):5885-93
pubmed: 27458209
Nat Rev Gastroenterol Hepatol. 2017 Mar;14(3):160-169
pubmed: 27899816
Clin Ther. 2016 Jan 1;38(1):204-10
pubmed: 26686826
J Antimicrob Chemother. 2018 Mar 1;73(3):564-568
pubmed: 29216348
Obstet Gynecol. 2011 Apr;117(4):877-82
pubmed: 21422859
Anaesth Crit Care Pain Med. 2019 Oct;38(5):549-562
pubmed: 30836191
Obes Surg. 2011 Jul;21(7):836-40
pubmed: 20198452
J Antimicrob Chemother. 2019 Jul 1;74(7):1975-1983
pubmed: 31220258
J Antimicrob Chemother. 2018 Nov 1;73(11):3087-3094
pubmed: 30137377
Eur J Clin Pharmacol. 2012 May;68(5):735-45
pubmed: 22246211
Crit Care. 2019 Mar 29;23(1):104
pubmed: 30925922
Am J Health Syst Pharm. 2013 Feb 1;70(3):195-283
pubmed: 23327981
Int J Antimicrob Agents. 2015 Oct;46(4):367-75
pubmed: 26271599
Br J Anaesth. 2018 Jun;120(6):1202-1208
pubmed: 29793587
Surgery. 2004 Oct;136(4):738-47
pubmed: 15467657
Antimicrob Agents Chemother. 2002 Sep;46(9):3026-30
pubmed: 12183263
Expert Rev Clin Pharmacol. 2019 Jul;12(7):623-634
pubmed: 31136211
Nature. 2000 Apr 6;404(6778):635-43
pubmed: 10766250
J Antimicrob Chemother. 2009 Dec;64(6):1307-15
pubmed: 19837713