Faculty of Health, University of Canberra, 1 Kirinari Street, Bruce, Canberra, ACT, 2617, Australia.
School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia.
Obes Surg. 2022 Sep;32(9):3138-3149. doi: 10.1007/s11695-022-06196-5. Epub 2022 Jul 9.
Currently, there is no consensus on whether a standard 2-g prophylactic cefazolin dose provides sufficient antimicrobial coverage in obese surgical patients. This systematic review analysed both outcome and pharmacokinetic studies, aiming to determine the appropriate cefazolin dose. A systematic search was conducted using 4 databases. In total, 3 outcome and 15 pharmacokinetic studies met the inclusion criteria. All 3 outcome studies concluded that there is no need for increased dose. Also, 9 pharmacokinetic studies reached this conclusion; however, 6 pharmacokinetic studies recommended that 2-g dose is insufficient to achieve adequate plasma or tissue concentrations. The stronger body of evidence supports that 2-g dose of cefazolin is sufficient for surgery lasting up to 4 h; however, large-scale outcome studies are needed to confirm this evidence.
目前，对于肥胖手术患者，标准的 2 克预防用头孢唑林剂量是否能提供足够的抗菌覆盖范围，尚无共识。本系统评价分析了结局和药代动力学研究，旨在确定合适的头孢唑林剂量。使用 4 个数据库进行了系统检索。共有 3 项结局研究和 15 项药代动力学研究符合纳入标准。所有 3 项结局研究的结论均为无需增加剂量。此外，9 项药代动力学研究也得出了同样的结论；然而，有 6 项药代动力学研究建议 2 克剂量不足以达到足够的血浆或组织浓度。更多的证据支持，2 克剂量的头孢唑林用于持续时间不超过 4 小时的手术是足够的；然而，需要进行大规模的结局研究来证实这一证据。
