Evidence map›Paper›PMID 37729151›Full record

ArticlePloS one2023

Peri-operative pharmacokinetics of cefazolin prophylaxis during valve replacement surgery.

Ahmad Alli, Fathima Paruk, Claire Roger, Jeffrey Lipman, Daren Calleemalay, Steven C Wallis, Juan Scribante, Guy A Richards, Jason A Roberts

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 4 countries.

Ahmad AlliDepartment of Anesthesiology and Pain Medicine, St Michael's Hospital, University of Toronto, Toronto, Canada.ORCID 0000-0003-4879-7090
Fathima ParukFaculty of Health Sciences, Department of Critical Care, University of Pretoria, Pretoria, South Africa.ORCID 0000-0002-6549-0106
Claire RogerDepartment of Anesthesiology, Critical Care Pain, and Emergency Medicine, Nimes University Hospital, Nimes, France.
Jeffrey LipmanUniversity of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Daren CalleemalayFaculty of Health Sciences, Department of Anesthesiology, University of Witwatersrand, Johannesburg, South Africa.ORCID 0000-0003-0572-2523
Steven C WallisUniversity of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Juan ScribanteSurgeons for Little Lives and Department of Paediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0002-2221-5024
Guy A RichardsFaculty of Health Sciences, Division of Critical Care, University of Witwatersrand, Johannesburg, South Africa.ORCID 0000-0002-8893-3934
Jason A RobertsUniversity of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
The University of Queensland · AUUniversity of the Witwatersrand · ZASt. Michael's Hospital · CAUniversity of Pretoria · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere is little prospective data to guide effective dosing for antibiotic prophylaxis during surgery requiring cardiopulmonary bypass (CPB). We aim to describe the effects of CPB on the population pharmacokinetics (PK) of total and unbound concentrations of cefazolin and to recommend optimised dosing regimens.

methodsPatients undergoing CPB for elective cardiac valve replacement were included using convenience sampling. Intravenous cefazolin (2g) was administered pre-incision and re-dosed at 4 hours. Serial blood and urine samples were collected and analysed using validated chromatography. Population PK modelling and Monte-Carlo simulations were performed using Pmetrics® to determine the fractional target attainment (FTA) of achieving unbound concentrations exceeding pre-defined exposures against organisms known to cause surgical site infections for 100% of surgery (100% fT>MIC).

resultsFrom the 16 included patients, 195 total and 64 unbound concentrations of cefazolin were obtained. A three-compartment linear population PK model best described the data. We observed that cefazolin 2g 4-hourly was insufficient to achieve the FTA of 100% fT>MIC for Staphylococcus aureus and Escherichia coli at serum creatinine concentrations ≤ 50 μmol/L and for Staphylococcus epidermidis at any of our simulated doses and serum creatinine concentrations. A dose of cefazolin 3g 4-hourly demonstrated >93% FTA for S. aureus and E. coli.

conclusionsWe found that cefazolin 2g 4-hourly was not able to maintain concentrations above the MIC for relevant pathogens in patients with low serum creatinine concentrations undergoing cardiac surgery with CPB. The simulations showed that optimised dosing is more likely with an increased dose and/or dosing frequency.

Indexed as

CefazolinEscherichia coliCreatinineHumansProspective StudiesStaphylococcus aureusCefazolinCreatinine

Identifiers

PMID37729151
PMCPMC10511078
OpenAlexW4386884277

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.