ArticlePharmacotherapy2024
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Article in Pharmacotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Cefazolin surgical prophylaxis in obesity: a body composition-driven population pharmacokinetic approach.Antimicrobial agents and chemotherapy · 2026Article
- β-Lactam Antibiotics in Obese Adults: A Review of Population Pharmacokinetic Analyses.Clinical pharmacokinetics · 2026Review
- The effect of intraoperative excessive bleeding on the pharmacokinetics of ampicillin and sulbactam in recipients of living donor liver transplantation in Japan.JAC-antimicrobial resistance · 2025Article
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
Abstract
introductionCefazolin is the leading antibiotic used to prevent surgical site infections worldwide. Consensus guidelines recommend adjustment of the cefazolin dose above and below 120 kg without regard to body composition. Algorithms exist to repurpose radiologic data into body composition (morphomics) and inform dosing decisions in obesity.
objectivesTo compare the current standard of body weight to morphomic measurements as covariates of cefazolin pharmacokinetics and aid dose stratification of cefazolin in patients with obesity undergoing colorectal surgery.
methodsThis prospective study measured cefazolin plasma, fat, and colon tissue concentrations in colorectal surgery patients in order to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in morbidly obese patients (n = 21, body mass index ≥35 kg/m
resultsMorphomics and pharmacokinetic data were available in 58 patients with a median [min, max] weight and age of 95.9 [68.5, 148.8] kg and 55 [25, 79] years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 and 0.060 by the PopPK and PBPK models, respectively. The estimated creatinine clearance (eCL
conclusionsKidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. Data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
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