title: Antibiotic prophylaxis in obese patients submitted to bariatric surgery. A systematic review.
abstract: OBJECTIVE
  To review the use of cefazolin in prophylaxis of surgical wound infection (SSI) in bariatric surgery (BS).
  
  
  METHODS
  A systematic review was performed from October to November, 2013 using the following databases: The Cochrane Library, Medline, LILACS, and EMBASE. The inclusion criteria were randomized clinical trials and observational studies that were evaluated by two independent reviewers.
  
  
  RESULTS
  Nine hundred and sixty one titles were recovered after preliminary analysis (title and abstract), seven studies remained for final analysis. There were three clinical trials (one with SSI, and two with antibiotic levels as the outcome), and four were observational studies (three cohorts and one case-control, all had SSI as the outcome). After administration of 1g or 2 g, levels of cefazolin in serum and tissue were suboptimal according to two studies. Results from observational studies indicated that different antibiotics were used for prophylaxis of SSI in BS and that use of other drugs may be associated with higher rates of SSI.
  
  
  CONCLUSIONS
  The use of cefazolin for surgical wound infection prophylaxis in bariatric surgery is recommended, however further studies are needed in order to refine parameters as initial dose, redose, moment of administration and lasting of prophylaxis.
authors.affiliation: Federal University of Rio Grande do Sul, Porto AlegreRS, Brazil, Fellow PhD degree, Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil. Conception of the study, acquisition and interpretation of data, manuscript writing.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Fischer
authors.affiliation: Federal University of Health Sciences of Porto Alegre, Department of Basic Health Sciences, Porto AlegreRS, Brazil, PhD, Associate Professor, Department of Basic Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre-RS, Brazil. Acquisition and interpretation of data, manuscript writing.
authors.forename: Cícero
authors.initials: C
authors.lastname: Dias
authors.affiliation: UFCSPA, Department of Public Health, Porto AlegreRS, Brazil, PhD, Chairman, Full Professor, Department of Public Health, UFCSPA, Lutheran University of Brazil(ULBRA), Porto Alegre-RS, Brazil. CNPq PQ2 Conception of the study, critical revision.
authors.forename: Airtontetelbom
authors.initials: A
authors.lastname: Stein
authors.affiliation: Conceição Hospital, Porto AlegreRS, Brazil, Head, Division of the Class III Obesity Care Center, Conceição Hospital, Porto Alegre-RS, Brazil. Conception of the study, critical revision.
authors.forename: Nelson Guardiola
authors.initials: NG
authors.lastname: Meinhardt
authors.affiliation: Obesity Care Center, Department of Drug Production and Control and Pharmaceutical Sciences, Porto AlegreRS, Brazil, PhD, Associate Professor, Department of Drug Production and Control and Pharmaceutical Sciences, UFRGS, Porto Alegre-RS, Brazil. Conception of the study, critical revision.
authors.forename: Isabela
authors.initials: I
authors.lastname: Heineck
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D050110:Bariatric Surgery; D002437:Cefazolin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D009765:Obesity / Q000601:surgery; D064887:Observational Studies as Topic; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin