Prophylactic cefazolin concentrations in morbidly obese patients undergoing sleeve gastrectomy: do we achieve targets?

Grégoire, Matthieu; Dumont, R.; Ronchi, L.; Woillard, Jean‐Baptiste; Atthar, Vincent; Letessier, E; Cinotti, Raphaël; Roquilly, Antoine; Deslandes, Guillaume; Jolliet, Pascale; Asehnoune, Karim; Dailly, Éric

doi:10.1016/j.ijantimicag.2018.02.015

Cited by 13 publications

(20 citation statements)

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“…Similar to previous works, renal function estimation was found to have a strong impact on cefazolin pharmacokinetics (11)(12)(13). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula was used as the estimator of the glomerular filtration rate (GFR) because it is more accurate overall (16)(17)(18).…”

Section: Discussionmentioning

confidence: 65%

“…Patient characteristics were heterogeneous, with a broad range of daily doses being administered (500 mg/day to 12,000 mg/day), considering a priori and a posteriori dose adaptation. In previous works, cefazolin pharmacokinetics were simulated with models with two or more compartments and with cefazolin administration as an intravenous bolus (11)(12)(13)(14). In our study, the one-compartment model was selected because of the continuous-infusion administration, which allowed cefazolin to reach steady state and thus achieve equilibrium between the central and peripheral compartments (15).…”

Section: Discussionmentioning

confidence: 99%

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Population Pharmacokinetic Study of Cefazolin Dosage Adaptation in Bacteremia and Infective Endocarditis Based on a Nomogram

Bellouard

Deschanvres

Deslandes

et al. 2019

Antimicrob Agents Chemother

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Optimal dosing of continuous-infusion cefazolin can be challenging in patients being treated for bacteremia or infective endocarditis. The aim of this work is to describe and analyze the pharmacokinetics of cefazolin in those patients using a population pharmacokinetics modeling approach and to establish a nomogram to determine the optimal daily dose. Population pharmacokinetics were modeled using the Pmetrics package for R. Plasma concentrations were collected retrospectively from patients treated with continuous-infusion cefazolin for bacteremia or infective endocarditis. The influence of multiple parameters, including renal function, total body weight, body mass index, body surface area (BSA), ideal weight, lean body weight, height, and age, was tested. The probabilities of target attainment for selected target concentrations (40, 60, and 80 mg/liter) were calculated. A dosing nomogram was then developed, using the absolute value of the glomerular filtration rate (aGFR), to determine the optimal daily dose required to achieve the target concentrations in at least 90% of patients. In total, 346 cefazolin plasma concentrations from 162 patients were collected. A one-compartment model best described the data set. The only covariate was aGFR, calculated according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and the patient’s body surface area, for the rate of elimination. Using the nomogram, achieving a cefazolin concentration target of 40 mg/liter with a success rate of at least 90% and with an aGFR of 30, 60, 90, and 120 ml/min requires a daily dose of 2.6, 4.3, 6.1, and 8.0 g/day, respectively. These results confirm the interest of posology adaptation of cefazolin according to aGFR.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Study of Cefazolin Dosage Adaptation in Bacteremia and Infective Endocarditis Based on a Nomogram

Bellouard

Deschanvres

Deslandes

et al. 2019

Antimicrob Agents Chemother

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“…Discussion/Conclusion: These converging results from complementary data sources suggest a quest for high doses of pregabalin out of any medical control, with a recent and sharp increase, which is concordant with the national addictovigilance monitoring [1,5]. These results are even more concerning given that pregabalin reverses opioid-induced tolerance, which can lead to respiratory depression and lethal overdose [6]. References: [1] Introduction: Pregabalin was initially not presented as having any abuse potential.…”

Section: Methodsmentioning

confidence: 72%

“…Same trends were observed in other countries, in parallel with misuse and abuse of gabapentin. Experimental and observational studies suggested a drug-drug interaction with opioids on respiratory depression and implication of pregabalin in deaths [6,7]. Discussion/Conclusion: The pregabalin abuse in France is a recent phenomenon, more marked since 2018, with visible health consequences.…”

Section: Methodsmentioning

confidence: 99%

“…Case analysis led to their classification in two clinical entities: VRESS (Virus Replication with Eosinophilia and Systemic symptoms Syndrome, n = 15), where herpesvirus infection preceded amoxicillin initiation, and DRESS (n = 214). Three onset circumstances were identified for DRESS: 1/"amoxicillin clear culprit" [n = 97, median TTO 4 days (IQR 2-10)]; 2/"amoxicillin possible culprit" [(other potential culprit drugs in addition to amoxicillin), n = 65, TTO 15 days (IQR [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Introduction: Serious Adverse Care Reactions (SACRs) are defined as unexpected events occurring during care (investigations, treatments and medical acts) whose consequences are death, life-threatening or probable permanent functional deficit. Since November 2016, health care professionals must declare every SACR on the official website of the Regional Health Agency (RHA) and complete "without delay" the initial report.…”

Section: Comentioning

confidence: 99%

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2021

Fundamemntal Clinical Pharma

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International consensus recommendations for the use of prolonged‐infusion beta‐lactam antibiotics: Endorsed by the American College of Clinical Pharmacy, British Society for Antimicrobial Chemotherapy, Cystic Fibrosis Foundation, European Society of Clinical Microbiology and Infectious Diseases, Infectious Diseases Society of America, Society of Critical Care Medicine, and Society of Infectious Diseases Pharmacists

Hong,

Downes,

FakhriRavari

et al. 2023

Pharmacotherapy

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Intravenous β‐lactam antibiotics remain a cornerstone in the management of bacterial infections due to their broad spectrum of activity and excellent tolerability. β‐lactams are well established to display time‐dependent bactericidal activity, where reductions in bacterial burden are directly associated with the time that free drug concentrations remain above the minimum inhibitory concentration (MIC) of the pathogen during the dosing interval. In an effort to take advantage of these bactericidal characteristics, prolonged (extended and continuous) infusions (PIs) can be applied during the administration of intravenous β‐lactams to increase time above the MIC. PI dosing regimens have been implemented worldwide, but implementation is inconsistent. We report consensus therapeutic recommendations for the use of PI β‐lactams developed by an expert international panel with representation from clinical pharmacy and medicine. This consensus guideline provides recommendations regarding pharmacokinetic and pharmacodynamic targets, therapeutic drug‐monitoring considerations, and the use of PI β‐lactam therapy in the following patient populations: severely ill and nonseverely ill adult patients, pediatric patients, and obese patients. These recommendations provide the first consensus guidance for the use of β‐lactam therapy administered as PIs and have been reviewed and endorsed by the American College of Clinical Pharmacy (ACCP), the British Society for Antimicrobial Chemotherapy (BSAC), the Cystic Fibrosis Foundation (CFF), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the Infectious Diseases Society of America (IDSA), the Society of Critical Care Medicine (SCCM), and the Society of Infectious Diseases Pharmacists (SIDP).

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Prophylactic cefazolin concentrations in morbidly obese patients undergoing sleeve gastrectomy: do we achieve targets?

Cited by 13 publications

References 30 publications

Population Pharmacokinetic Study of Cefazolin Dosage Adaptation in Bacteremia and Infective Endocarditis Based on a Nomogram

Population Pharmacokinetic Study of Cefazolin Dosage Adaptation in Bacteremia and Infective Endocarditis Based on a Nomogram

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