Obesity Surgery

, Volume 24, Issue 9, pp 1487–1491 | Cite as

Antibiotic Prophylaxis in Bariatric Surgery with Continuous Infusion of Cefazolin: Determination of Concentration in Adipose Tissue

  • Rafael Anlicoara
  • Álvaro A. B. Ferraz
  • Kilma da P. Coelho
  • José L. de Lima Filho
  • Luciana T. Siqueira
  • José G. C. de AraújoJr.
  • Josemberg M. Campos
  • Edmundo M. Ferraz
Original Contributions
First Online:

Abstract

Background

The aim of this study was to evaluate the concentration of cefazolin in adipose tissue of patients undergoing bariatric surgery.

Methods

Eighteen patients undergoing bariatric surgery were evaluated during the period from October 2011 to May 2012. All patients had a dosage schedule of antibiotic prophylaxis with cefazolin administered as follows: first, 2 g in anesthetic induction, followed by continuous infusion of 1 g diluted in 250 ml of saline solution. Adipose samples, collected soon after the incision (initial) and before the skin synthesis (final), were analyzed using reverse phase high-pressure liquid chromatography. The level of significance adopted was 5 %.

Results

The cefazolin concentration in the adipose tissue samples at the beginning of surgery was an average of 6.66 ± 2.56 ug/ml. The mean concentration before the skin synthesis was 7.93 ± 2.54 ug/ml. Patients with BMI < 40 kg/m2 had higher initial and final sample concentrations of cefazolin than patients with BMI ≥ 40 kg/m2. There was no surgical site infection (SSI) in any of the patients.

Conclusions

In bariatric surgeries, addition of a 1 g increase of cefazolin, administered through continuous intravenous infusion, to the currently recommended dose of 2 g administered in anesthetic induction provided a concentration in the adipose tissue above the minimum inhibitory concentration (MIC) of the main causal agents of SSI. An inverse correlation between BMI and concentration of cefazolin in adipose tissue was observed.

Keywords

Obesity Bariatric surgery Cefazolin Antimicrobial prophylaxis 
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Notes

Conflict of Interests

The antibiotic manufacturer did not participate in this study, and there were no conflicts of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rafael Anlicoara
    • 1
  • Álvaro A. B. Ferraz
    • 2
  • Kilma da P. Coelho
    • 3
  • José L. de Lima Filho
    • 3
  • Luciana T. Siqueira
    • 4
  • José G. C. de AraújoJr.
    • 4
  • Josemberg M. Campos
    • 4
  • Edmundo M. Ferraz
    • 4
  1. 1.Department of Plastic SurgeryUFPERecifeBrazil
  2. 2.Hospital das Clínicas UFPERecifeBrazil
  3. 3.Department of Bioquemistry, Laboratory of Immunopathology Keizo AsamiUFPERecifeBrazil
  4. 4.Department of SurgeryUFPERecifeBrazil

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