Clinical Pharmacy department, Collage of Pharmacy, Umm Al-Qura University, Mecca, Mecca Province, Saudi Arabia; School of Pharmacy, Institute of Clinical Sciences, Robert Aitken Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
School of Pharmacy, Institute of Clinical Sciences, Robert Aitken Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2019 Nov;242:71-78. doi: 10.1016/j.ejogrb.2019.08.022. Epub 2019 Aug 31.
Intravenous (IV) Cefuroxime (CFX) is widely used in Caesarean Section (CS) as a prophylactic antibiotic. The objective of this systematic review to compare CFX concentration in maternal blood and adipose tissue with the incidence of surgical site infection (SSI) following IV CFX in non-obese and obese women undergoing CS. A search in Medline, EMBASE, Cochrane, Web of Science, CINHAL Plus, Scopus and Google Scholar was conducted without language or date restrictions. Published articles or abstracts reporting CFX concentration or rates of SSI following CFX IV administration in adult women requiring CS were included. Studies were screened by title and abstract. Quality of studies was assessed via the ClinPK Statement checklist (Pharmacokinetics studies), or Joanna Briggs Institute Critical Appraisal Tools (SSI studies). The Cochrane Effective Practice and Organisation of Care checklist evaluated the risk of bias (SSI studies). There were no studies evaluating CFX concentrations in obese women undergoing CS. For non-obese women, CFX plasma concentrations ranged from 9.85 to 95.25 mg/L within 30-60 min of administration (1500 mg dose; 4 articles, n = 108 women). Plasma CFX concentrations were above the minimum inhibitory concentration (8 mg/L) for up to 3 h post-dose. No studies reported on CFX concentration in adipose tissue. Reported rates of SSI were 4.7% and 6.8% after administration of a single 1500 mg dose of CFX administrated after cord clamping (n = 144 women). There is limited data on pharmacokinetics of CFX for CS. There were no studies that reported CFX concentrations or SSI in obese women.
静脉注射头孢呋辛（CFX）在剖宫产中被广泛用作预防性抗生素。本系统评价的目的是比较非肥胖和肥胖妇女在剖宫产中接受 CFX 静脉注射后，CFX 在母血和脂肪组织中的浓度与手术部位感染（SSI）的发生率。检索 Medline、EMBASE、Cochrane、Web of Science、CINHAL Plus、Scopus 和 Google Scholar，不限制语言或日期。纳入了报告 CFX 浓度或 CFX 静脉注射后 SSI 发生率的成年妇女剖宫产时 CFX 浓度或 SSI 发生率的已发表文章或摘要。通过标题和摘要筛选研究。通过临床 PK 声明清单（药代动力学研究）或 Joanna Briggs 研究所批判性评价工具（SSI 研究）评估研究质量。Cochrane 有效实践和护理组织清单评估了 SSI 研究的偏倚风险。没有评估肥胖妇女 CFX 浓度的研究。对于非肥胖妇女，CFX 血浆浓度在 30-60 分钟内给予 1500mg 剂量后为 9.85-95.25mg/L（4 篇文章，n=108 名妇女）。CFX 给药后 3 小时内，CFX 血浆浓度仍高于最低抑菌浓度（8mg/L）。没有研究报告 CFX 在脂肪组织中的浓度。在脐带夹闭后给予单次 1500mg CFX 剂量后，报告的 SSI 发生率分别为 4.7%和 6.8%（n=144 名妇女）。CFX 在剖宫产中的药代动力学数据有限。没有研究报告肥胖妇女 CFX 浓度或 SSI。
