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- Title
Pharmacodynamic Evaluation of a Single Dose versus a 24-Hour Course of Multiple Doses of Cefazolin for Surgical Prophylaxis.
- Authors
Heffernan, Aaron; Alawie, Jowana; Wallis, Steven C; Naicker, Saiyuri; Adiraju, Santosh; Roberts, Jason A.; Sime, Fekade Bruck; Jullien, Vincent
- Abstract
The optimal perioperative duration for the administration of cefazolin and other prophylactic antibiotics remains unclear. This study aimed to describe the pharmacodynamics of cefazolin for a single 2 g dose versus a 24 h course of a 2 g single dose plus a 1 g eight-hourly regimen against methicillin-susceptible Staphylococcus aureus. Static concentration time–kill assay and a dynamic in vitro hollow-fibre infection model simulating humanised plasma and interstitial fluid exposures of cefazolin were used to characterise the pharmacodynamics of prophylactic cefazolin regimens against methicillin-sensitive Staphylococcus aureus clinical isolates. The initial inoculum was 1 × 105 CFU/mL to mimic a high skin flora inoculum. The static time–kill study showed that increasing the cefazolin concentration above 1 mg/L (the MIC) did not increase the rate or the extent of bacterial killing. In the dynamic hollow-fibre model, both dosing regimens achieved similar bacterial killing (~3-log CFU/mL within 24 h). A single 2 g dose may be adequate when low bacterial burdens (~104 CFU/mL) are anticipated in an immunocompetent patient with normal pharmacokinetics.
- Subjects
CEFAZOLIN; EXTRACELLULAR fluid; STAPHYLOCOCCUS aureus; PREVENTIVE medicine; ANTIBIOTICS; OXYGENATORS; ANTIBIOTIC prophylaxis
- Publication
Antibiotics (2079-6382), 2021, Vol 10, Issue 5, p602
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics10050602