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Prophylactic Cefazolin Dosing and Surgical Site Infections: Does the Dose Matter in Obese Patients?

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Hussain, Z ORCID: 0000-0003-0819-3380, Curtain, C ORCID: 0000-0001-5029-7541, Mirkazemi, C ORCID: 0000-0002-2345-6313, Gadd, K, Peterson, GM ORCID: 0000-0002-6764-3882 and Zaidi, STR ORCID: 0000-0002-2031-1055 2018 , 'Prophylactic Cefazolin Dosing and Surgical Site Infections: Does the Dose Matter in Obese Patients?' , Obesity Surgery , pp. 1-7 , doi: 10.1007/s11695-018-3497-0.

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Abstract

Background:Most surgical prophylaxis guidelines recommend a 3-g cefazolin intravenous dose in patients weighing ≥ 120 kg. However, this recommendation is primarily based on pharmacokinetic studies rather than robust clinical evidence. This study aimed to compare the prevalence of surgical site infections (SSIs) in obese and non-obese patients (body mass index ≥ 30 kg/m2 and Methods:A retrospective case-control study was conducted in adult elective surgical patients. Patients receiving 2- g cefazolin were grouped as obese and non-obese, and by weight (≥ 120 kg or Results:We identified 152 obese (median 134 kg) and 152 non-obese control (median 73 kg) patients. Baseline characteristics were similar between groups, except for an increased prevalence in the obese group of diabetes (35.5% vs 13.2%; p p n = 102) compared to those weighing n = 202) (9.8% vs 5.0%; p = 0.17).Conclusion:The prevalence of SSI was not significantly increased in obese patients, or those weighing ≥ 120 kg, who received cefazolin 2- g prophylactically; however, trends toward an increase were evident. Large-scale randomised trials are needed to examine whether a 2-g or 3-g cefazolin is adequate to prevent SSI in obese (and ≥ 120 kg) individuals.

Item Type: Article
Authors/Creators:Hussain, Z and Curtain, C and Mirkazemi, C and Gadd, K and Peterson, GM and Zaidi, STR
Keywords: obesity surgery cefazolin drug dosing infection prophylaxis
Journal or Publication Title: Obesity Surgery
Publisher: F D-Communications Inc
ISSN: 0960-8923
DOI / ID Number: 10.1007/s11695-018-3497-0
Copyright Information:

Copyright 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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