title: Effects of renal function on the pharmacokinetics and pharmacodynamics of prophylactic cefazolin in cardiothoracic surgery.
abstract: The purpose of this investigation was to study the effects of renal function on the pharmacokinetics and pharmacodynamics (PK-PD) of free cefazolin administered prophylactically in cardiothoracic surgery. Patients received an initial 2-g dose of cefazolin, followed by 1-g doses 6, 12, 18 and 24 h after the first dose. In patients who underwent cardiopulmonary bypass, 1 g was added to the priming solution. In 35 patients with a normal estimated creatinine clearance (CLcr) ≥50 ml/min, a free cefazolin concentration <4 μg/ml was observed in 11.4, 5.7 and 54.3% of patients before the second dose, at the end and 24 h after operation, respectively. In contrast, only 7.4% of 27 patients with CLcr <49 ml/min had a free cefazolin concentration <4 μg/ml 24 h after the operation. There was a high negative correlation between CLcr and time above the target minimal inhibitory concentration (MIC) when the CLcr was <50 ml/min (r(2) = 0.807), and no correlation when the CLcr was ≥50 ml/min. Renal function has a significant impact on the PK-PD of prophylactic cefazolin in cardiothoracic surgery. The postoperative drug dosing intervals should be <6 h in order to achieve a 100% time above the MIC in patients with CLcr ≥ 50 ml/min.
authors: Department of Pharmacy, Kyoto Prefectural University, School of Medicine, Kyoto, Japan.
authors: T
authors: T
authors: Kosaka
authors: K
authors: K
authors: Hosokawa
authors: N
authors: N
authors: Shime
authors: F
authors: F
authors: Taniguchi
authors: T
authors: T
authors: Kokufu
authors: S
authors: S
authors: Hashimoto
authors: H
authors: H
authors: Fujiwara
authors: H
authors: H
authors: Yaku
authors: N
authors: N
authors: Sugioka
authors: K
authors: K
authors: Okada
authors: N
authors: N
authors: Fujita
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