Observational studyThe Journal of antimicrobial chemotherapy2026
Pharmacokinetics of cefazolin in bariatric surgery patients: a preoperative perspective.
Observational study in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
BACKGROUND AND
objectivesOptimal cefazolin dosing for surgical prophylaxis in patients with severe obesity remains controversial, particularly regarding tissue exposure at the surgical site. Plasma concentrations may not reliably reflect pharmacologically active antibiotic levels in target tissues. This study aims to characterize total and calculated unbound concentrations of cefazolin in subcutaneous adipose tissue, dermis and plasma in patients with severe obesity undergoing bariatric surgery, and to assess pharmacodynamic target attainment across clinically relevant MIC thresholds.
methodsIn this prospective observational study, patients undergoing sleeve gastrectomy received cefazolin prophylaxis according to current guidelines (2 or 3 g intravenously). Plasma, dermis and adipose tissue samples were collected at incision (T0), 30 min (T30) and end of surgery (Tend). Total cefazolin concentrations were quantified using validated HPLC methods. Concentration-time profiles were analysed using linear mixed-effects models adjusted for age, BMI and creatinine clearance. Target attainment was evaluated at MIC thresholds of 2, 4 and 8 mg/L.
resultsDermis and plasma total cefazolin concentrations consistently exceeded all MIC thresholds in both dosing groups, whereas adipose tissue concentrations were more variable, with reduced attainment at higher MICs. Calculated unbound cefazolin concentrations demonstrated marked matrix-dependent differences: plasma unbound levels consistently exceeded all targets, dermal unbound concentrations increased significantly from T0 to Tend and adipose tissue unbound concentrations remained low across all time points. Increasing the dose from 2 to 3 g modestly improved total adipose tissue target attainment but did not substantially enhance unbound adipose tissue exposure. No surgical site infections occurred.
conclusionsIn patients with severe obesity, guideline-recommended cefazolin dosing provides adequate plasma and dermis exposure but fails to ensure reliable unbound adipose tissue concentrations. These findings highlight the limitations of plasma-based assessments and support tissue-informed, individualized prophylactic strategies in bariatric surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.