Several Department of Anesthesiology colleagues have recently published a research paper in the Journal of Clinical Medicine titled “Dosing Cefazolin for Surgical Site Infection Prophylaxis in Adolescent Idiopathic Scoliosis Surgery: Intermittent Bolus or Continuous Infusion?—A Pilot Study” (available online ahead of print). Their study examined the efficacy of different cefazolin dosing strategies in preventing surgical site infections after posterior spinal fusion for adolescent idiopathic scoliosis, one of the most frequently reported complications. The research, which compared intermittent bolus dosing with continuous infusion, reveals that while both methods achieve effective tissue concentration levels, continuous infusion may offer superior bactericidal concentration benefits.
Christoph Seubert, M.D., Ph.D., DABNM, FASA, professor of anesthesiology and neurosurgery, was the senior author for the article. Other co-authors from the Department of Anesthesiology included:
- Cole Dooley, M.D., assistant professor of anesthesiology
- Anna Woods, R.N., clinical research coordinator III
- Cyndi Garvan, Ph.D., statistician and professor of anesthesiology
In this pilot study, the researchers assessed plasma levels of cefazolin and utilized a clinical microdialysis method to measure the drug’s concentrations in skeletal muscle and subcutaneous fat. They compared cefazolin administration methods and evaluated how long cefazolin levels remained effective against methicillin-sensitive Staphylococcus aureus and gram-negative bacteria in patient groups. Their findings indicated that although both dosing regimens provided adequate global drug exposure in plasma, the continuous infusion method resulted in higher cefazolin concentrations in subcutaneous and muscle tissues. This study underscores the feasibility of intraoperative cefazolin tissue concentration monitoring and highlights the potential advantages of continuous infusion dosing in ensuring effective infection prevention.
“Our study demonstrates administration of cefazolin by continuous infusion intraoperatively results in higher plasma, subcutaneous adipose tissue, and muscle concentrations of cefazolin in healthy patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis than cefazolin administration by intermittent bolus,” noted the authors. “Continuous infusion is more likely to result in antibiotic concentrations that are bactericidal and should reduce the likelihood of surgical site infections in this population.”
University of Florida College of Medicine colleagues Yichao Yu, M.S., Hardik Chandasana, Ph.D., and Elham Amini, Pharm.D., Ph.D., from the Department of Pharmaceutics, Stephanie Ihnow, M.D., from the Department of Orthopaedic Surgery & Sports Medicine, and Amy Gunnett, R.N., BSN, former manager of our Clinical Research Office and currently manager of the Phase One and Experimental Therapeutics Group at the UF Health Cancer Center, also contributed as co-authors. Laurel C. Blakemore, M.D., of Pediatric Specialists of Virginia and Taran Sangari, M.D., MBA, of the University of California at San Francisco joined them in co-authoring the research.
Congratulations to the authors!