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Pharmacodynamic Evaluation of a Single Dose versus a 24-Hour Course of Multiple Doses of Cefazolin for Surgical Prophylaxis

1
School of Pharmacy, The University of Queensland, Woolloongabba, Brisbane, QLD 4103, Australia
2
School of Medicine, Griffith University, Southport, Gold Cost, QLD 4222, Australia
3
University of Queensland Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Brisbane, QLD 4029, Australia
4
Department of Intensive Care Medicine and Pharmacy Department, Royal Brisbane and Women’s Hospital, Herston, Brisbane, QLD 4029, Australia
5
Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, 30900 Nîmes, France
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Vincent Jullien
Received: 16 April 2021 / Revised: 15 May 2021 / Accepted: 16 May 2021 / Published: 19 May 2021
(This article belongs to the Special Issue Antibiotic Usage in Acute Situations)
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. View Full-Text
Keywords: cefazolin; pharmacodynamics; surgical prophylaxis; staphylococcus aureus cefazolin; pharmacodynamics; surgical prophylaxis; staphylococcus aureus
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MDPI and ACS Style

Heffernan, A.; Alawie, J.; Wallis, S.C.; Naicker, S.; Adiraju, S.; Roberts, J.A.; Sime, F.B. Pharmacodynamic Evaluation of a Single Dose versus a 24-Hour Course of Multiple Doses of Cefazolin for Surgical Prophylaxis. Antibiotics 2021, 10, 602. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10050602

AMA Style

Heffernan A, Alawie J, Wallis SC, Naicker S, Adiraju S, Roberts JA, Sime FB. Pharmacodynamic Evaluation of a Single Dose versus a 24-Hour Course of Multiple Doses of Cefazolin for Surgical Prophylaxis. Antibiotics. 2021; 10(5):602. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10050602

Chicago/Turabian Style

Heffernan, Aaron, Jowana Alawie, Steven C. Wallis, Saiyuri Naicker, Santosh Adiraju, Jason A. Roberts, and Fekade B. Sime 2021. "Pharmacodynamic Evaluation of a Single Dose versus a 24-Hour Course of Multiple Doses of Cefazolin for Surgical Prophylaxis" Antibiotics 10, no. 5: 602. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10050602

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