Antibiotic Prophylaxis in Bariatric Surgery with Continuous Infusion of Cefazolin: Determination of Concentration in Adipose Tissue

Antibiotic Prophylaxis in Bariatric Surgery with Continuous Infusion of Cefazolin: Determination of Concentration in Adipose Tissue

Background The aim of this study was to evaluate the concentration of cefazolin in adipose tissue of patients undergoing bariatric surgery. Methods Eighteen patients undergoing bariatric surgery were evaluated during the period from October 2011 to May 2012. All patients had a dosage schedule of ant...

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Bibliographic Details
Published in:Obesity surgery Vol. 24; no. 9; pp. 1487 - 1491
Main Authors: Anlicoara, Rafael, Ferraz, Álvaro A. B., da P. Coelho, Kilma, de Lima Filho, José L., Siqueira, Luciana T., de Araújo, José G. C., Campos, Josemberg M., Ferraz, Edmundo M.
Format: Journal Article
Language:English
Published: Boston Springer US 01-09-2014
Springer Nature B.V
Subjects:
Adipose Tissue - chemistry
Adult
Anti-Bacterial Agents - analysis
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis - methods
Antibiotics
Bariatric Surgery - methods
Body fat
Cefazolin - analysis
Cefazolin - therapeutic use
Chromatography, High Pressure Liquid
Female
Gastrointestinal surgery
Humans
Infusions, Intravenous
Male
Medicine
Medicine & Public Health
Middle Aged
Obesity
Obesity - surgery
Original Contributions
Surgery
Surgical Wound Infection - prevention & control
Obesity
Antimicrobial prophylaxis
Cefazolin
Bariatric surgery
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Summary:Background The aim of this study was to evaluate the concentration of cefazolin in adipose tissue of patients undergoing bariatric surgery. Methods Eighteen patients undergoing bariatric surgery were evaluated during the period from October 2011 to May 2012. All patients had a dosage schedule of antibiotic prophylaxis with cefazolin administered as follows: first, 2 g in anesthetic induction, followed by continuous infusion of 1 g diluted in 250 ml of saline solution. Adipose samples, collected soon after the incision (initial) and before the skin synthesis (final), were analyzed using reverse phase high-pressure liquid chromatography. The level of significance adopted was 5 %. Results The cefazolin concentration in the adipose tissue samples at the beginning of surgery was an average of 6.66 ± 2.56 ug/ml. The mean concentration before the skin synthesis was 7.93 ± 2.54 ug/ml. Patients with BMI < 40 kg/m 2 had higher initial and final sample concentrations of cefazolin than patients with BMI ≥ 40 kg/m 2 . There was no surgical site infection (SSI) in any of the patients. Conclusions In bariatric surgeries, addition of a 1 g increase of cefazolin, administered through continuous intravenous infusion, to the currently recommended dose of 2 g administered in anesthetic induction provided a concentration in the adipose tissue above the minimum inhibitory concentration (MIC) of the main causal agents of SSI. An inverse correlation between BMI and concentration of cefazolin in adipose tissue was observed.
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ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-014-1231-0