Trial reportAntimicrobial agents and chemotherapy2016
Pharmacokinetic and Pharmacodynamic Evaluation of a Weight-Based Dosing Regimen of Cefoxitin for Perioperative Surgical Prophylaxis in Obese and Morbidly Obese Patients.
Trial report in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Weight-based dosing of surgical antibiotic prophylaxis in patients with obesity: meta-analysis.BJS open · 2025Pooled it
- β-Lactam Antibiotics in Obese Adults: A Review of Population Pharmacokinetic Analyses.Clinical pharmacokinetics · 2026Review
- Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing.Journal of translational medicine · 2025Article
- Durlobactam to boost the clinical utility of standard of care β-lactams againstAntimicrobial agents and chemotherapy · 2025Article
- Article
- Interaction of Cephalosporins with Human Serum Albumin: A Structural Study.Journal of medicinal chemistry · 2024Article
- Antibiotics in anesthesia and critical care.Annals of translational medicine · 2024Review
- Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery.Antibiotics (Basel, Switzerland) · 2023Review
- Pharmacokinetic/Pharmacodynamic Target Attainment of Vancomycin, at Three Reported Infusion Modes, for Methicillin-ResistantFrontiers in cellular and infection microbiology · 2022Article
- Predicted Vancomycin Dosage Requirement in Patients With Hematological Malignancies and Dosage Dynamic Adjustment.Frontiers in pharmacology · 2022Article
- Clinical Pharmacokinetic and Pharmacodynamic Considerations in the Drug Treatment of Non-Tuberculous Mycobacteria in Cystic Fibrosis.Clinical pharmacokinetics · 2021Review
- Influence of the Obesity Phenotype on the Adequacy of Antibiotic Prophylaxis with Cefoxitin for Obese Patients Undergoing Bariatric Surgery: Lessons Learnt and Future Considerations.European journal of drug metabolism and pharmacokinetics · 2021Article
- Competence Mining of Vancomycin (VAN) in the Management of Infections Due to Bacterial Strains With High VAN Minimum Inhibitory Concentrations (MICs): A Novel Dosing Strategy Based on Pharmacokinetic/Pharmacodynamic Modeling.Frontiers in microbiology · 2021Article
- Impact of Obesity on Ceftriaxone Efficacy.Diseases (Basel, Switzerland) · 2020Article
- Antibiotic prophylaxis with high-dose cefoxitin in bariatric surgery: an observational prospective single center study.Antimicrobial agents and chemotherapy · 2019Article
- Pharmacodynamic model for β-lactam regimens used in surgical prophylaxis: model-based evaluation of standard dosing regimens.International journal of clinical pharmacy · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The objective of this study was to determine the pharmacokinetics and pharmacodynamics (PK/PD) of a weight-based cefoxitin dosing regimen for surgical prophylaxis in obese patients. Patients received a single dose of cefoxitin at 40 mg/kg based on total body weight. Cefoxitin samples were obtained over 3 h from serum and adipose tissue, and concentrations were determined by validated high-performance liquid chromatography. Noncompartmental pharmacokinetic analysis was performed, followed by Monte Carlo simulations to estimate probability of target attainment (PTA) for Staphylococcus aureus, Escherichia coli, and Bacteroides fragilis over 4-h periods postdose. Thirty patients undergoing bariatric procedures were enrolled. The body mass index (mean ± standard deviation [SD])was 45.9 ± 8.0 kg/m(2) (range, 35.0 to 76.7 kg/m(2)); the median cefoxitin dose was 5 g (range, 4.0 to 7.5 g). The mean maximum concentrations were 216.15 ± 41.80 μg/ml in serum and 12.62 ± 5.89 in tissue; the mean tissue/serum ratio was 8% ± 3%. In serum, weight-based regimens achieved ≥90% PTA (goal time during which free [unbound] drug concentrations exceed pathogen MICs [fT>MIC] of 100%) for E. coli and S. aureus over 2 h and for B. fragilis over 1 h; in tissue this regimen failed to achieve goal PTA at any time point. The 40-mg/kg regimens achieved higher PTAs over longer periods in both serum and tissue than did the standard 2-g doses. However, although weight-based cefoxitin regimens were better than fixed doses, achievement of desired pharmacodynamic targets was suboptimal in both serum and tissue. Alternative dosing regimens and agents should be explored in order to achieve more favorable antibiotic performance during surgical prophylaxis in obese patients.
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