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

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• 作者：Rafael Anlicoara (1)
  álvaro A. B. Ferraz (2)
  Kilma da P. Coelho (3)
  José L. de Lima Filho (3)
  Luciana T. Siqueira (4)
  José G. C. de Araújo Jr. (4)
  Josemberg M. Campos (4)
  Edmundo M. Ferraz (4)
  
• 关键词：Obesity ; Bariatric surgery ; Cefazolin ; Antimicrobial prophylaxis
• 刊名：Obesity Surgery
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：24
• 期：9
• 页码：1487-1491
• 全文大小：147 KB
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• 作者单位：Rafael Anlicoara (1)
  álvaro A. B. Ferraz (2)
  Kilma da P. Coelho (3)
  José L. de Lima Filho (3)
  Luciana T. Siqueira (4)
  José G. C. de Araújo Jr. (4)
  Josemberg M. Campos (4)
  Edmundo M. Ferraz (4)
  
  1. Department of Plastic Surgery, UFPE, Recife, Pernambuco, Brazil
  2. Hospital das Clínicas UFPE, Recife, Pernambuco, Brazil
  3. Department of Bioquemistry, Laboratory of Immunopathology Keizo Asami, UFPE, Recife, Pernambuco, Brazil
  4. Department of Surgery, UFPE, Recife, Pernambuco, Brazil
  
• ISSN：1708-0428

文摘

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?±-.56?ug/ml. The mean concentration before the skin synthesis was 7.93?±-.54?ug/ml. Patients with BMI--0?kg/m2 had higher initial and final sample concentrations of cefazolin than patients with BMI?≥-0?kg/m2. 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.