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Incidence of surgical infection in cefazolin 3 g versus 2 g for colorectal surgery in obese patients

Published online by Cambridge University Press:  09 January 2025

Curtis D. Collins Open the ORCID record for Curtis D. Collins [Opens in a new window] ,
Eric Hartsfield ,
Robert K. Cleary ,
Rachel M. Kenney ,
Michael P. Veve Open the ORCID record for Michael P. Veve [Opens in a new window]  and
Kara K. Brockhaus Open the ORCID record for Kara K. Brockhaus [Opens in a new window]
Curtis D. Collins*
Affiliation:
Department of Pharmacy Services, Trinity Health Ann Arbor, Ann Arbor, MI, USA
Eric Hartsfield
Affiliation:
Department of Pharmacy Services, Trinity Health Ann Arbor, Ann Arbor, MI, USA
Robert K. Cleary
Affiliation:
Department of Colon and Rectal Surgery, Trinity Health Ann Arbor, Ann Arbor, MI, USA
Rachel M. Kenney
Affiliation:
Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA
Michael P. Veve
Affiliation:
Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
Kara K. Brockhaus
Affiliation:
Department of Pharmacy Services, Trinity Health Ann Arbor, Ann Arbor, MI, USA
*
Corresponding author: Curtis D. Collins; Email: [email protected]
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Abstract

Objective:

To compare the incidence of surgical site infection (SSI) between cefazolin 3 g and 2 g surgical prophylaxis in patients weighing ≥120 kg that undergo elective colorectal surgery.

Methods:

A multicenter, retrospective cohort study was performed utilizing a validated database of elective colorectal surgeries in Michigan acute care hospitals. Adults weighing ≥120 kg who received cefazolin and metronidazole for surgical prophylaxis between 7/2012 and 6/2021 were included. The primary outcome was SSI, which was defined as an infection diagnosed within 30 days following the principal operative procedure. Multivariable logistic regression was used to identify variables associated with SSI; the exposure of interest was cefazolin 3 g surgical prophylaxis.

Results:

A total of 581 patients were included; of these, 367 (63.1%) received cefazolin 3 g, while 214 (36.8%) received 2 g. Patients who received cefazolin 3 g had less optimal antibiotic timing (324 [88.3%] vs 200 [93.5%]; P = .043) and a higher receipt of at least 1 of the prophylaxis antibiotics after incision (22 [6%] vs 5 [2.3%]; P = .043). There was no SSI difference between cefazolin 3 g and 2 g cohorts (23 [6.3%] vs 16 [7.5%], P = .574). When accounting for age, smoking status, and surgical duration, cefazolin 3 g was not associated with a reduction in SSI (adjOR, .64; 95%CI, .32–1.29).

Conclusions:

Surgical prophylaxis with cefazolin 3 g, in combination with metronidazole, was not associated with decreased SSI compared to 2 g dosing in obese patients undergoing elective colorectal surgery.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 46 , Issue 2 , February 2025 , pp. 115 - 119
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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