Baseel Dania, Kim Juliana, Mohammed Sumayya, Lowe Andrew, Siddiqi Javed
Medical School, Boston University, Boston, USA.
Medical School, University of California Berkeley, Berkeley, USA.
Cureus. 2022 May 13;14(5):e24979. doi: 10.7759/cureus.24979. eCollection 2022 May.
Background Preoperative antibiotic prophylaxis is a method of administering antibiotics prior to surgical procedures to decrease surgical site infections. The Center for Disease Control and Prevention (CDC) guidelines recommend administering the chosen antibiotic within 60 minutes prior to incision. However, further research can be conducted to explore and determine a more precise and ideal time for preoperative antibiotic prophylaxis. Methods This paper explores the most used antibiotics within the Department of Neurosurgery at Arrowhead Regional Medical Center, which are cefazolin and clindamycin, and pinpoints the ideal time of preoperative antibiotic prophylaxis based on peak serum levels. It will present and discuss findings by analyzing the pharmacokinetic profiles of each antibiotic, focusing on the minimal inhibitory concentration (MIC), time to peak in the tissue, and duration of action to determine the appropriate time for redosing. Results Our findings indicate that based on the pharmacological profiles, the ideal time to administer preoperative antibiotics for cefazolin is 40 minutes prior to incision, and for clindamycin is 45 minutes prior to incision. Conclusions This study may help guide clinical decision-making and lead to minimizing the rate of infections and decreasing hospital stay.
背景 术前抗生素预防是在手术前使用抗生素以减少手术部位感染的一种方法。疾病控制与预防中心（CDC）指南建议在切开前60分钟内使用选定的抗生素。然而，可以进行进一步研究以探索和确定术前抗生素预防更精确和理想的时间。方法 本文探讨了箭头区域医疗中心神经外科最常用的抗生素头孢唑林和克林霉素，并根据血清峰值水平确定术前抗生素预防的理想时间。它将通过分析每种抗生素的药代动力学特征来呈现和讨论研究结果，重点关注最低抑菌浓度（MIC）、组织中达到峰值的时间和作用持续时间，以确定再次给药的合适时间。结果 我们的研究结果表明，根据药理学特征，头孢唑林术前抗生素给药的理想时间是切开前40分钟，克林霉素是切开前45分钟。结论 本研究可能有助于指导临床决策，并有助于将感染率降至最低并缩短住院时间。
