Plasma and Tissue Cefazolin Concentrations in Obese Patients Undergoing Cesarean Delivery and Receiving Differing Pre-Operative Doses of Drug

Stitely, Michael L.; Sweet, Michael; Slain, Douglas; Alons, Lindsy; Holls, William M.; Hochberg, Charles J.; Briggs, Frank

doi:10.1089/sur.2012.040

Cited by 41 publications

(36 citation statements)

References 20 publications

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“…As a natural extension of this finding, 21 studies evaluated differential drug dosage based on body weight (Supporting Information Table S15). Eighteen studies observed higher drug dosage to be more effective in patients with obesity (62,117,119,129,133,134,136,140,145,155,158,159,(163)(164)(165)167,169,183). Nine studies examined the vaccination response and the majority (115,132,139,162,174,175), but not all (121,166) studies reported a reduced serological response in obesity to rabies, hepatitis B and influenza vaccines.…”

Section: Does the Patient Response To Prevention Or Treatment Of Infementioning

confidence: 99%

Interaction of obesity and infections

2015

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There is evidence that certain infections may induce obesity. Obese persons may also have more severe infections and have compromised response to therapies. The objective of this study is to review the available literature identifying infections that potentially contribute to greater body mass index (BMI) and differential responses of overweight and obese persons to infections. A systematic literature review of human studies examining associations between infections and weight gain, differential susceptibility, severity, and response to prevention and treatment of infection according to BMI status (January 1980-July 2014) was conducted. Three hundred and forty-three studies were eligible for inclusion. Evidence indicated that viral infection by human adenovirus Ad36 and antibiotic eradication of Helicobacter pylori were followed by weight gain. People who were overweight or obese had higher susceptibility to developing post-surgical infections, H1N1 influenza and periodontal disease. More severe infections tended to be present in people with a larger BMI. People with a higher BMI had a reduced response to vaccinations and antimicrobial drugs. Higher doses of antibiotics were more effective in obese patients. Infections may influence BMI, and BMI status may influence response to certain infections, as well as to preventive and treatment measures. These observations have potential clinical implications.

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Section: Does the Patient Response To Prevention Or Treatment Of Infementioning

confidence: 99%

Interaction of obesity and infections

2015

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“…In an experimental study evaluating 20 obese patients receiving 2 or 4 g of cefazolin before CS, all collected subcutaneous and myometrial tissue samples had antibiotic concentrations above the minimal inhibitory levels, and no infectious complications occurred [25]. In another series of 29 patients given 2 g of cefazolin 30e60 min before CS, antibiotic concentrations in wound adipose tissues were inversely proportional to maternal BMI and a considerable percentage of women with a BMI >30 kg/m 2 did not achieve minimal inhibitory concentrations for gram-negative rods at skin incision, but all reached this level at skin closure [26].…”

Section: Appropriate Dose Of Prophylactic Antibioticsmentioning

confidence: 99%

Obesity and the challenges of caesarean delivery: Prevention and management of wound complications

Ayres-de-Campos¹

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…[6][7][8] Substantial evidence currently exists to validate the safety of this antibiotic in pregnant women and to verify the effectiveness of cefazolin in reducing the rate of postoperative surgical wound infections. 7,9 The American Congress of Obstetricians and Gynecologists currently recommends antimicrobial prophylaxis with a single 1-g dose of cefazolin within 60 minutes before the start of cesarean delivery. 10 Current recommendations regarding clinical dose adjustments for patients with variable body types range from 2 to 3 g per dose.…”

Section: Introductionmentioning

confidence: 99%