Journal
OBESITY SURGERY
Volume 32, Issue 9, Pages 3138-3149Publisher
SPRINGER
DOI: 10.1007/s11695-022-06196-5
Keywords
Obesity; Cefazolin; Dosing; Surgical site infection; Prophylaxis
Categories
Funding
- CAUL
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There is currently no consensus on whether an increased cefazolin dose is necessary for obese surgical patients. A systematic review of outcome and pharmacokinetic studies found that a 2-g dose of cefazolin is sufficient for surgery lasting up to 4 hours, but large-scale outcome studies are needed to confirm this conclusion.
Currently, there is no consensus on whether a standard 2-g prophylactic cefazolin dose provides sufficient antimicrobial coverage in obese surgical patients. This systematic review analysed both outcome and pharmacokinetic studies, aiming to determine the appropriate cefazolin dose. A systematic search was conducted using 4 databases. In total, 3 outcome and 15 pharmacokinetic studies met the inclusion criteria. All 3 outcome studies concluded that there is no need for increased dose. Also, 9 pharmacokinetic studies reached this conclusion; however, 6 pharmacokinetic studies recommended that 2-g dose is insufficient to achieve adequate plasma or tissue concentrations. The stronger body of evidence supports that 2-g dose of cefazolin is sufficient for surgery lasting up to 4 h; however, large-scale outcome studies are needed to confirm this evidence.
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