Higher Cefazolin Dose fails to Reduce SSIs in Obese Patients: Study

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 and a higher receipt of at least 1 of the prophylaxis antibiotics after incision. There was no SSI difference between cefazolin 3 g and 2 g cohorts. When accounting for age, smoking status, and surgical duration, cefazolin 3 g was not associated with a reduction in SSI. 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.

Reference:

Collins CD, Hartsfield E, Cleary RK, Kenney RM, Veve MP, Brockhaus KK. Incidence of surgical infection in cefazolin 3 g versus 2 g for colorectal surgery in obese patients. Infection Control & Hospital Epidemiology. Published online 2025:1-5. doi:10.1017/ice.2024.215