Eduardo Celia Palma1, Nelson Guardiola Meinhardt2, Airton Tetelbom Stein2, Isabela Heineck3, Maria Isabel Fischer3, BibianaVerlindo de Araújo1, Teresa Dalla Costa4. 1. Pharmacokinetics and PK/PD Modeling Laboratory, Pharmaceutical Sciences Graduate Program, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, Porto Alegre, RS, 90.610-000, Brazil. 2. Center for Obese Class III Care, Nossa Senhora Conceição Hospital (HNSC), Porto Alegre, RS, Brazil. 3. Pharmaceutical Sciences Graduate Program, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. 4. Pharmacokinetics and PK/PD Modeling Laboratory, Pharmaceutical Sciences Graduate Program, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, Porto Alegre, RS, 90.610-000, Brazil. dalla.costa@ufrgs.br.
Abstract
PURPOSE: To determine the efficacious cefazolin prophylactic dose for bariatric surgery using free subcutaneous concentrations accessed by microdialysis after 2 g or 3 g i.v. bolus dosing to morbidly obese women and POPPK modeling. METHODS: A POPPK model with variable plasma and subcutaneous tissue protein binding was developed to simultaneously describe plasma and tissue data sets. The outcomes was predicted for common surgical site infection (SSI) bacteria over 3, 4, 5 and 6 h periods postdose, as probability of target attainment (PTA) using Monte Carlo simulation. RESULTS: CFZ 2 g warrant up to 5 h SSI prophylaxis for bacteria with MICs ≤1 mg/L such as Escherichia coli and Staphylococcus aureus. For species such as Klebsiella pneumoniae, which present MIC distribution frequency of 2 mg/L, the maintenance of PTA ≥ 90% occurs with a 3 g dose for surgeries lasting up to 5 h, and 2 g dose provide an adequate response up to 4 h (PTA of 89%). CONCLUSIONS: Effectiveness of CFZ 2 g is similar to 3 g against bacteria with a MIC up to 2 mg/L, especially if the surgery does not last for more than 4 h.
PURPOSE: To determine the efficacious cefazolin prophylactic dose for bariatric surgery using free subcutaneous concentrations accessed by microdialysis after 2 g or 3 g i.v. bolus dosing to morbidly obesewomen and POPPK modeling. METHODS: A POPPK model with variable plasma and subcutaneous tissue protein binding was developed to simultaneously describe plasma and tissue data sets. The outcomes was predicted for common surgical site infection (SSI) bacteria over 3, 4, 5 and 6 h periods postdose, as probability of target attainment (PTA) using Monte Carlo simulation. RESULTS: CFZ 2 g warrant up to 5 h SSI prophylaxis for bacteria with MICs ≤1 mg/L such as Escherichia coli and Staphylococcus aureus. For species such as Klebsiella pneumoniae, which present MIC distribution frequency of 2 mg/L, the maintenance of PTA ≥ 90% occurs with a 3 g dose for surgeries lasting up to 5 h, and 2 g dose provide an adequate response up to 4 h (PTA of 89%). CONCLUSIONS: Effectiveness of CFZ 2 g is similar to 3 g against bacteria with a MIC up to 2 mg/L, especially if the surgery does not last for more than 4 h.
Authors: Jane W A Vella-Brincat; Evan J Begg; Carl M J Kirkpatrick; Mei Zhang; Stephen T Chambers; Kate Gallagher Journal: Br J Clin Pharmacol Date: 2007-01-12 Impact factor: 4.335
Authors: Vanessa P Ho; David P Nicolau; Gregory F Dakin; Alfons Pomp; Barrie S Rich; Christopher W Towe; Philip S Barie Journal: Surg Infect (Larchmt) Date: 2012-02-08 Impact factor: 2.150
Authors: Benedetta Allegranzi; Bassim Zayed; Peter Bischoff; N Zeynep Kubilay; Stijn de Jonge; Fleur de Vries; Stacey M Gomes; Sarah Gans; Elon D Wallert; Xiuwen Wu; Mohamed Abbas; Marja A Boermeester; E Patchen Dellinger; Matthias Egger; Petra Gastmeier; Xavier Guirao; Jianan Ren; Didier Pittet; Joseph S Solomkin Journal: Lancet Infect Dis Date: 2016-11-02 Impact factor: 25.071
Authors: Melinda A Maggard; Lisa R Shugarman; Marika Suttorp; Margaret Maglione; Harvey J Sugerman; Harvey J Sugarman; Edward H Livingston; Ninh T Nguyen; Zhaoping Li; Walter A Mojica; Lara Hilton; Shannon Rhodes; Sally C Morton; Paul G Shekelle Journal: Ann Intern Med Date: 2005-04-05 Impact factor: 25.391
Authors: Benedetta Allegranzi; Peter Bischoff; Stijn de Jonge; N Zeynep Kubilay; Bassim Zayed; Stacey M Gomes; Mohamed Abbas; Jasper J Atema; Sarah Gans; Miranda van Rijen; Marja A Boermeester; Matthias Egger; Jan Kluytmans; Didier Pittet; Joseph S Solomkin Journal: Lancet Infect Dis Date: 2016-11-02 Impact factor: 25.071
Authors: Margreke J E Brill; Aletta P I Houwink; Stephan Schmidt; Eric P A Van Dongen; Eric J Hazebroek; Bert van Ramshorst; Vera H Deneer; Johan W Mouton; Catherijne A J Knibbe Journal: J Antimicrob Chemother Date: 2013-11-08 Impact factor: 5.790
Authors: Rafael Anlicoara; Álvaro A B Ferraz; Kilma da P Coelho; José L de Lima Filho; Luciana T Siqueira; José G C de Araújo; Josemberg M Campos; Edmundo M Ferraz Journal: Obes Surg Date: 2014-09 Impact factor: 4.129
Authors: Rochelle L Ryan; Dwane Jackson; George Hopkins; Victoria Eley; Rebecca Christensen; Andre A J Van Zundert; Steven C Wallis; Jeffrey Lipman; Suzanne L Parker; Jason A Roberts Journal: Antimicrob Agents Chemother Date: 2022-06-28 Impact factor: 5.938