Plasma and Tissue Concentration of Cefazolin in Preoperative Prophylaxis in Patients Undergoing Bariatric Surgery

NCT ID: NCT07253805

Last Updated: 2025-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-04-11

Study Completion Date

2026-02-01

Brief Summary

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This study investigates whether current cefazolin dosing guidelines for obese patients-2 g IV for those \<120 kg and 3 g IV for those ≥120 kg-achieve adequate plasma and tissue concentrations (≥8 mg/L) for effective surgical prophylaxis. While several retrospective and prospective studies suggest that a 2 g dose may be sufficient regardless of weight, findings are inconsistent and often rely solely on plasma concentrations. Given that tissue concentration at the site of action is a more relevant pharmacokinetic marker, the study emphasizes the need to measure cefazolin levels in adipose tissue. Previous research using microdialysis has shown reduced tissue distribution in obese patients, potentially warranting higher doses. The study also highlights variability in defining the minimum inhibitory concentration (MIC) required for prophylaxis, noting that 8 mg/L is often considered the threshold for Enterobacteriaceae. Ultimately, the study aims to clarify whether current dosing achieves effective antibiotic levels across different weight categories, with a focus on tissue concentrations.

Detailed Description

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Conditions

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Bariatric Sleeve Gastrectomy Cefazolin

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Clindamycin group/control

A control group of 10 patients undergoing sleeve gastrectomy at the Quebec Heart and Lung Institute, who have not been exposed to cefazolin due to penicillin allergy, will be recruited to validate the analytical method. During surgery, biopsies of adipose and dermal tissue and blood samples will be collected. No other antibiotic or medications will be administered to these patients.

No interventions assigned to this group

Ancef group

Sixty patients will be recruited for the study, with 20 patients assigned to each weight category. Recruitment will take place during the preoperative consultation at the bariatric surgery clinic. All patients expressing interest will be included, provided they do not meet any exclusion criteria (convenience sampling). During surgery, biopsies of adipose and dermal tissue and blood samples, will be collected. No additional antibiotics or medications will be administered to these patients.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Have a BMI ≥ 35 kg/m²
* Undergo bariatric surgery (sleeve gastrectomy) via laparoscopy

Exclusion Criteria

* Under 18 years of age
* Weight over 180 kg
* Penicillin allergy
* Pregnant or breastfeeding women
* Chronic kidney disease (eGFR \< 60 ml/min according to the Cockcroft-Gault equation)
* Liver cirrhosis
* Intraoperative blood loss ≥ 1 liter
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation IUCPQ

OTHER

Sponsor Role collaborator

Laval University

OTHER

Sponsor Role lead

Responsible Party

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François Julien

General and Bariatric Surgeon, and Clinical Researcher, MD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval

Québec, Quebec, Canada

Site Status

Countries

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Canada

References

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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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Other Identifiers

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CER 21626, 2019-3053

Identifier Type: -

Identifier Source: org_study_id

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