当前位置： SCI文献检索 > EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY期刊下所有文献 > Pharmacokinetics and protein binding of cefazolin in morbidly obese patients.

Pharmacokinetics and protein binding of cefazolin in morbidly obese patients.

Abstract：

PURPOSE:The aim of this study was to assess the pharmacokinetics and protein binding of cefazolin in morbidly obese patients undergoing bariatric surgery, to study the influence of bodyweight measures and age on pharmacokinetic parameters and to evaluate unbound cefazolin concentrations over time in this population. METHODS:Twenty morbidly obese patients (bodyweight 112-260 kg, body mass index 38-79 kg m(-2)) were studied following the administration of cefazolin 2 g at induction of anaesthesia. Blood samples were collected up to 4 h post-dosing to determine total and unbound plasma cefazolin concentrations. Non-compartmental pharmacokinetic data analysis was performed. RESULTS:Cefazolin clearance was 4.2 ± 1.0 L h(-1) (mean ± standard deviation) and showed a negative correlation with age (p = 0.003) but not with bodyweight measures (p > 0.05). Volume of distribution was 13.0 ± 3.1 L and correlated positively with bodyweight measures (p ≤ 0.001). Saturable protein binding was observed with a median protein binding of 79% (interquartile range 74-82), which proved similar to reported protein binding in non-obese patients. In all patients, unbound cefazolin concentrations remained above 1 mg L(-1) (minimal inhibitory concentration for 90% (MIC(90)) of methicillin-sensitive isolates of Staphylococcus aureus in Europe) until 4 h post-dosing. CONCLUSIONS:Younger age--and not bodyweight--was significantly associated with higher cefazolin clearance. However, as in all patients with bodyweights up to 260 kg, unbound plasma cefazolin concentrations remained above 1 mg L(-1) until 4 h after the intravenous administration of a 2-g dose. As such, re-dosing within 4 h or dosing with another antibiotic class should only be considered in the case of a higher MIC(90) of the local isolates.

journal_name

Eur J Clin Pharmacol

journal_title

European journal of clinical pharmacology

authors

van Kralingen S,Taks M,Diepstraten J,van de Garde EM,van Dongen EP,Wiezer MJ,van Ramshorst B,Vlaminckx B,Deneer VH,Knibbe CA

doi

10.1007/s00228-011-1048-x

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

985-92

issue

eissn

0031-6970

issn

1432-1041

journal_volume

pub_type

临床试验,杂志文章

在线工具

Pharmacokinetics and protein binding of cefazolin in morbidly obese patients.