Prophylactic Cefazolin Dosing in Obesity—a Systematic Review

Matthew Coates, Alison Shield, Greg Peterson, Zahid Hussain

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Currently, there is no consensus on whether a standard 2-g prophylactic cefazolin dose provides sufficient antimicrobial coverage in obese surgical patients. This systematic review analysed both outcome and pharmacokinetic studies, aiming to determine the appropriate cefazolin dose. A systematic search was conducted using 4 databases. In total, 3 outcome and 15 pharmacokinetic studies met the inclusion criteria. All 3 outcome studies concluded that there is no need for increased dose. Also, 9 pharmacokinetic studies reached this conclusion; however, 6 pharmacokinetic studies recommended that 2-g dose is insufficient to achieve adequate plasma or tissue concentrations. The stronger body of evidence supports that 2-g dose of cefazolin is sufficient for surgery lasting up to 4 h; however, large-scale outcome studies are needed to confirm this evidence.

Original languageEnglish
Pages (from-to)3138–3149
Number of pages12
JournalObesity Surgery
Issue number9
Publication statusPublished - 9 Jul 2022


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