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Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer

BACKGROUND: Few studies have reported the dosage of cefmetazole (CMZ) for intraoperative antimicrobial prophylaxis in patients underwent surgery for colorectal cancer. We therefore examined the optimal intraoperative dosage of CMZ according to pharmacokinetic/pharmacodynamic (PK/PD) theory in patien...

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Autores principales: Tomizawa, Atsushi, Nakamura, Takatoshi, Komatsu, Toshiaki, Inano, Hiroshi, Kondo, Rumiko, Watanabe, Masahiko, Atsuda, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219696/
https://www.ncbi.nlm.nih.gov/pubmed/28074152
http://dx.doi.org/10.1186/s40780-016-0071-6
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author Tomizawa, Atsushi
Nakamura, Takatoshi
Komatsu, Toshiaki
Inano, Hiroshi
Kondo, Rumiko
Watanabe, Masahiko
Atsuda, Koichiro
author_facet Tomizawa, Atsushi
Nakamura, Takatoshi
Komatsu, Toshiaki
Inano, Hiroshi
Kondo, Rumiko
Watanabe, Masahiko
Atsuda, Koichiro
author_sort Tomizawa, Atsushi
collection PubMed
description BACKGROUND: Few studies have reported the dosage of cefmetazole (CMZ) for intraoperative antimicrobial prophylaxis in patients underwent surgery for colorectal cancer. We therefore examined the optimal intraoperative dosage of CMZ according to pharmacokinetic/pharmacodynamic (PK/PD) theory in patients who undergoing surgery for colorectal cancer. METHODS: The study group comprised 23 patients with colorectal cancer who underwent surgery, using CMZ as antimicrobial treatment to prevent postoperative infection. CMZ was administered intravenously within 60 min before surgery. PK/PD analysis was performed by population pharmacokinetic analysis and Monte-Carlo simulation. RESULTS: The final population pharmacokinetic parameters of CMZ were as follows: CL(CMZ) = 0.0704 × creatinine clearance (Ccr) and Vd(CMZ) = 0.163 × body weight (Bw). In patients with a Ccr of ≥90 to <130 mL/min, the probability of achieving concentrations exceeding MIC was 52.9 to 82.2% at 2 h after the initial dose and less than 20% at 3 h after the initial dose. CONCLUSIONS: Additional doses of CMZ should be given every 2 h in patients with a Ccr of ≥90 to <130 mL/min, every 3 h in those with a Ccr of ≥50 to <90 mL/min, and every 4 to 5 h in those with a Ccr of ≥10 to <50 mL/min.
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spelling pubmed-52196962017-01-10 Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer Tomizawa, Atsushi Nakamura, Takatoshi Komatsu, Toshiaki Inano, Hiroshi Kondo, Rumiko Watanabe, Masahiko Atsuda, Koichiro J Pharm Health Care Sci Research Article BACKGROUND: Few studies have reported the dosage of cefmetazole (CMZ) for intraoperative antimicrobial prophylaxis in patients underwent surgery for colorectal cancer. We therefore examined the optimal intraoperative dosage of CMZ according to pharmacokinetic/pharmacodynamic (PK/PD) theory in patients who undergoing surgery for colorectal cancer. METHODS: The study group comprised 23 patients with colorectal cancer who underwent surgery, using CMZ as antimicrobial treatment to prevent postoperative infection. CMZ was administered intravenously within 60 min before surgery. PK/PD analysis was performed by population pharmacokinetic analysis and Monte-Carlo simulation. RESULTS: The final population pharmacokinetic parameters of CMZ were as follows: CL(CMZ) = 0.0704 × creatinine clearance (Ccr) and Vd(CMZ) = 0.163 × body weight (Bw). In patients with a Ccr of ≥90 to <130 mL/min, the probability of achieving concentrations exceeding MIC was 52.9 to 82.2% at 2 h after the initial dose and less than 20% at 3 h after the initial dose. CONCLUSIONS: Additional doses of CMZ should be given every 2 h in patients with a Ccr of ≥90 to <130 mL/min, every 3 h in those with a Ccr of ≥50 to <90 mL/min, and every 4 to 5 h in those with a Ccr of ≥10 to <50 mL/min. BioMed Central 2017-01-07 /pmc/articles/PMC5219696/ /pubmed/28074152 http://dx.doi.org/10.1186/s40780-016-0071-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Tomizawa, Atsushi
Nakamura, Takatoshi
Komatsu, Toshiaki
Inano, Hiroshi
Kondo, Rumiko
Watanabe, Masahiko
Atsuda, Koichiro
Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
title Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
title_full Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
title_fullStr Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
title_full_unstemmed Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
title_short Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
title_sort optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219696/
https://www.ncbi.nlm.nih.gov/pubmed/28074152
http://dx.doi.org/10.1186/s40780-016-0071-6
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