Introduction
Varied body regions have varying amounts of surgical site infections following damage or reconstructive surgery. Closure fracture surgeries and initial arthroplasty complication rates are reduced by antibiotic prophylaxis. Prophylactic antibiotics must be present in adequate quantities at the surgical site in order to avoid complications.
Research Question
- What are the cefazolin intended levels following orthopedic surgery in the limbs?
- How do the specific site level and cefazolin dosage affect the location of a particular area?
The objective of the given systematic review was to answer the questions regarding the concentration of cefazolin and its dosage. No aims and rationale were discovered during the analysis.
Study Design
Cephalosporins, orthopedics, extremities, surgical techniques, and pharmacokinetics were among the search terms used. RCTs or prospective cohort studies examining target site antimicrobial levels in human, mature participants who received prophylactic cefazolin in an IV injection dose prior to orthopedic or trauma treatment of the limb were suitable for inclusion. After complete text filtering, 14 studies were finally incorporated into the comprehensive study.
Additional Population Criteria
Studies were eliminated according to the following criteria: population (when included, clients received restorative antimicrobial drugs up to a week prior to surgical procedure or had peripheral arterial ailment), invasion (cephalosporin instead of cefazolin), design of the study (evaluations or publications only obtainable as abstract), and conclusion (only serum concentrations evaluated).
Variables
The dependent variable is the body location of the patient. Meanwhile, the independent variable, which influences the aforementioned variable, is cefazolin, whose concentrations and dosages.
Results
Increased bone concentrations were observed after 2 g than previously in studies evaluating different dosages of cefazolin, although pooling findings did not reveal a statistically significant change.
Limitations to the Study
The majority of research used data that had been gathered before the year 2000, which frequently led to poor documentation and potentially outmoded analysis techniques. Additionally, selection bias might well have arisen since only reasonably healthy patients were included in the majority of trials, which only comprised choice orthopedic surgery. Furthermore, less than half of the data could be pooled due to the significant variation in the sampling techniques, computation, and analysis. Third, patient or surgical factors might affect antibiotic target location levels. Overall, with emphasis solely on soft tissue samples and outdated materials, the paper might be subjective and less reliable.
Conclusions
I would not use this information at HSS due to its outdated and limited sample. The population is too narrow for HSS, yet the results of the observations might be clinically significant. As it was a systematic review that used evident models, it would be possible to replicate the study without contacting the author.
Reference
Sanders, F. R., Goslings, J. C., Mathôt, R. A., & Schepers, T. (2019). Target site antibiotic concentrations in orthopedic/trauma extremity surgery: Is prophylactic cefazolin adequately dosed? A systematic review and meta-analysis. Acta Orthopaedica, 90(2), 97-104.