Cefazoline: dose of 3 gram is recommended for patients weighing >120kg by IDSA
Pineda, Erika
Hello,
What are facilities doing in regards patients with Obesity having surgery, would anyone care to share in regards to your dosing practices are you following the ASHP/IDSA… guidelines?
Cefazoline: dose of 3 gram is recommended for patients weighing >120kg by IDSA
“Perioperative prophylaxis:
Manufacturer’s labeling: IM, IV: 1 to 2 g initiated 30 to 60 minutes prior to surgery; may repeat after 2 hours if procedure is lengthy with 500 mg to 1 g intraoperatively, followed by 500 mg to 1 g every 6 to 8 hours for 24 hours postoperatively.
Guideline recommendations (off-label): IV: Note: For most surgical procedures, joint clinical practice guidelines from the American Society of Health-System Pharmacists, Infectious Diseases Society of America, Surgical Infection Society, and Society for Healthcare Epidemiology of America (ASHP/IDSA/SIS/SHEA) recommend a dose of 2 g within 60 minutes prior to surgical incision (for nonobese patients weighing <120 kg). For procedures requiring anaerobic coverage (eg, appendectomy, small bowel surgery with intestinal obstruction, colon procedures), combine cefazolin with metronidazole as an alternative to a second generation cephalosporin with anaerobic activity (eg, cefoxitin or cefotetan). Cefazolin doses may be repeated intraoperatively in 4 hours if procedure is lengthy or if there is excessive blood loss (Bratzler 2013).
Obesity: The ASHP/IDSA/SIS/SHEA guidelines recommend that for patients weighing ≥120 kg, a dose of 3 g within 60 minutes prior to surgical incision should be administered (Bratzler 2013). Alternatively, for patients with BMI >40 kg/m2, a single 2 g dose may be sufficient for common general surgical procedures lasting <5 hours; patients enrolled in this multigroup study had a BMI up to a group mean of 55.7 kg/m2 (Ho 2012).”
Thanks,
Erika
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