Population pharmacokinetic model of cefazolin in total hip arthroplasty

Abstract Cefazolin is an antibiotic recommended for infection prevention in total hip arthroplasty (THA). However, the dosing regimen necessary to achieve therapeutic concentrations in obese patients remains unclear. The aim of this study was to conduct a population analysis of cefazolin pharmacokin...

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Autores principales:	J. Lanoiselée, R. Chaux, S. Hodin, S. Bourayou, A. Gibert, R. Philippot, S. Molliex, P. J. Zufferey, X. Delavenne, E. Ollier
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9d8cb41e8767483e89cc9dfa07139002
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spelling	oai:doaj.org-article:9d8cb41e8767483e89cc9dfa071390022021-12-02T17:13:17ZPopulation pharmacokinetic model of cefazolin in total hip arthroplasty10.1038/s41598-021-99162-72045-2322https://doaj.org/article/9d8cb41e8767483e89cc9dfa071390022021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99162-7https://doaj.org/toc/2045-2322Abstract Cefazolin is an antibiotic recommended for infection prevention in total hip arthroplasty (THA). However, the dosing regimen necessary to achieve therapeutic concentrations in obese patients remains unclear. The aim of this study was to conduct a population analysis of cefazolin pharmacokinetics (PK) and assess whether cefazolin administration should be weight adapted in THA. Adult patients undergoing THA surgery received an injection of 2000 mg of cefazolin, doubled in the case of BMI > 35 kg/m2 and total body weight > 100 kg. A population PK study was conducted to quantify cefazolin exposure over time compared to the therapeutic concentration threshold. A total of 484 cefazolin measurements were acquired in 100 patients, of whom 29% were obese. A 2-compartment model best fitted the data, and creatinine clearance determined interpatient variability in elimination clearance. Our PK simulations using a 2000 mg cefazolin bolus showed that cefazolin concentrations remained above the threshold throughout surgery, regardless of weight or renal function. A 2000 mg cefazolin single injection without adaptation to weight or renal function and without intraoperative reinjection was efficient in maintaining therapeutic concentrations throughout surgery. The optimal target concentration and necessary duration of its maintenance remain unclear.J. LanoiseléeR. ChauxS. HodinS. BourayouA. GibertR. PhilippotS. MolliexP. J. ZuffereyX. DelavenneE. OllierNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q J. Lanoiselée R. Chaux S. Hodin S. Bourayou A. Gibert R. Philippot S. Molliex P. J. Zufferey X. Delavenne E. Ollier Population pharmacokinetic model of cefazolin in total hip arthroplasty
description	Abstract Cefazolin is an antibiotic recommended for infection prevention in total hip arthroplasty (THA). However, the dosing regimen necessary to achieve therapeutic concentrations in obese patients remains unclear. The aim of this study was to conduct a population analysis of cefazolin pharmacokinetics (PK) and assess whether cefazolin administration should be weight adapted in THA. Adult patients undergoing THA surgery received an injection of 2000 mg of cefazolin, doubled in the case of BMI > 35 kg/m2 and total body weight > 100 kg. A population PK study was conducted to quantify cefazolin exposure over time compared to the therapeutic concentration threshold. A total of 484 cefazolin measurements were acquired in 100 patients, of whom 29% were obese. A 2-compartment model best fitted the data, and creatinine clearance determined interpatient variability in elimination clearance. Our PK simulations using a 2000 mg cefazolin bolus showed that cefazolin concentrations remained above the threshold throughout surgery, regardless of weight or renal function. A 2000 mg cefazolin single injection without adaptation to weight or renal function and without intraoperative reinjection was efficient in maintaining therapeutic concentrations throughout surgery. The optimal target concentration and necessary duration of its maintenance remain unclear.
format	article
author	J. Lanoiselée R. Chaux S. Hodin S. Bourayou A. Gibert R. Philippot S. Molliex P. J. Zufferey X. Delavenne E. Ollier
author_facet	J. Lanoiselée R. Chaux S. Hodin S. Bourayou A. Gibert R. Philippot S. Molliex P. J. Zufferey X. Delavenne E. Ollier
author_sort	J. Lanoiselée
title	Population pharmacokinetic model of cefazolin in total hip arthroplasty
title_short	Population pharmacokinetic model of cefazolin in total hip arthroplasty
title_full	Population pharmacokinetic model of cefazolin in total hip arthroplasty
title_fullStr	Population pharmacokinetic model of cefazolin in total hip arthroplasty
title_full_unstemmed	Population pharmacokinetic model of cefazolin in total hip arthroplasty
title_sort	population pharmacokinetic model of cefazolin in total hip arthroplasty
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9d8cb41e8767483e89cc9dfa07139002
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Population pharmacokinetic model of cefazolin in total hip arthroplasty

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