title: Optimal dosage of cefmetazole for intraoperative antimicrobial prophylaxis in patients undergoing surgery for colorectal cancer.
abstract: 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: CLCMZ= 0.0704 × creatinine clearance (Ccr) and VdCMZ= 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.
authors.affiliation: Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tomizawa
authors.affiliation: Department of Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Komatsu
authors.affiliation: Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inano
authors.affiliation: Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Rumiko
authors.initials: R
authors.lastname: Kondo
authors.affiliation: Department of Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374 Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Atsuda
keywords: Antimicrobial prophylaxis; Cefmetazole; Colorectal surgery; Population pharmacokinetics