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Pharmacodynamic Evaluation of a Single Dose versus a 24-Hour Course of Multiple Doses of Cefazolin for Surgical Prophylaxis
oleh: Aaron Heffernan, Jowana Alawie, Steven C Wallis, Saiyuri Naicker, Santosh Adiraju, Jason A. Roberts, Fekade Bruck Sime
Format: | Article |
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Diterbitkan: | MDPI AG 2021-05-01 |
Deskripsi
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 <i>Staphylococcus aureus</i>. 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 <i>Staphylococcus aureus</i> clinical isolates. The initial inoculum was 1 × 10<sup>5</sup> 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 (~10<sup>4</sup> CFU/mL) are anticipated in an immunocompetent patient with normal pharmacokinetics.