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Pharmacokinetics and Safety of Cefazolin 3gm DUPLEX in Adults (3gCefPK)

Primary Purpose

Infections

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cefazolin 3gm for Injection USP and Dextrose Injection USP
Sponsored by
B. Braun Medical Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Infections focused on measuring Cephalosporin, antibiotic, infection control, surgical prophylaxis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male or female aged >/= 18 years;
  2. Must weigh >/= 120 kg
  3. Able to understand and sign the Informed Consent Form(s) (ICF);
  4. Is scheduled for surgery that is expected to last less than 3 hours;
  5. Is scheduled for any type of surgery where a single-dose perioperative cefazolin prophylaxis is appropriate.

Exclusion Criteria:

  1. If female, is pregnant or lactating/breastfeeding.
  2. If female that is of childbearing potential and sexually active, and is not using an effective method of birth control, e.g., oral contraceptives, double barrier methods, hormonal injectable or implanted contraceptives, tubal ligation, or have a partner with a vasectomy.
  3. Has a history of renal impairment -- Subject has an eGFR of <80 mL/min/1.73m2 performed at Screening as calculated by the following equation: 186 x (Creatinine/88.4)-1.154 x (Age)-0.203 x (0.742 if female) x (1.210 if black) (FDA Guidance for Industry Pharmacokinetics in Patients with Impaired Renal Function)
  4. Has a known allergy or hypersensitivity to β lactam/cephalosporin antibiotics, corn products, or dextrose-containing products or solutions, or any of the other ingredients of Cefazolin for Injection United States Pharmacopeia (USP) and Dextrose Injection USP in DUPLEX.
  5. Has a result of any laboratory test (or repeat test, if done), obtained as standard of care, that is outside the normal limit of the site's laboratory reference range AND is considered by the investigator to be clinically significant.
  6. Has had a recent (within 14 days prior to the planned surgery) administration of cefazolin.
  7. Has had administration of any medication (e.g., prescription, herbal, over-the-counter medication[s] or dietary supplements) known to interact with cefazolin within 5 days prior to the study treatment administration.
  8. Has a known history of human immunodeficiency virus, hepatitis B, or hepatitis C infection.
  9. Has a current history of medical condition(s), which in the opinion of the investigator, would interfere with the evaluation of the study treatment.
  10. Has a known history of organ transplant.
  11. Has a clinically relevant disease/dysfunction of or a history of severe cardiac, pulmonary or hepatic disease.
  12. Is undergoing any cardiovascular procedure including, but not limited to, major cardiac surgery, cardiac catheterizations (including electrophysiology studies), ablations, automatic implantable cardioverter-defibrillator (AICD), and pacemaker.
  13. Has received any other investigational drug/device within 30 days prior to the study treatment administration.
  14. Has any planned medical intervention or personal event that might interfere with ability to comply with the study requirements.
  15. The subject has any condition that, in the opinion of the investigator, would compromise the safety of the subject or the quality of the data.
  16. Is unable or unwilling to adhere to the study-specified procedures and restrictions.
  17. Is an employee of the Sponsor, Investigator or study-center, has direct involvement in the study or other studies under the direction of that Investigator or study-center, or is a family member of the employees or the Investigator.

Sites / Locations

  • IACT Health - Roswell - IACT - HyperCore - PPDSRecruiting
  • Hightower Clinical, LLCRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cefazolin 3gm Injection

Arm Description

Study drug will be administrated as an infusion over 30 minutes starting approximately 0.5 hours before surgery begins and following institutional guidelines on Day 1 (day of surgery). All subjects will have five (5) individual whole blood samples (4 mL each) collected for the estimation of cefazolin concentration in plasma at the following times after the start of the infusion: 0.5 (+/-10 min) end of infusion, 1 h (+/-15 min), 2 h (+/-15 min), 4 h (+/-15 min), and 8 h (+/-15 min).

Outcomes

Primary Outcome Measures

Cefazolin plasma concentration following infusion
Concentrations will be determined through analysis of 5 blood samples drawn at 0.5 (end of infusion), 1, 2, 4, and 8 hours after the start of study drug infusion.

Secondary Outcome Measures

Number of participants with Treatment-Emergent Adverse Events [Safety] according to Study Protocol
Safety will be assessed by monitoring adverse events (AEs), physical examination, vital signs, and clinical laboratory tests.
Hematology: Hemoglobin (Hb)
gm/dL
Hematology: Hematocrit (Hct)
Hematology: mean corpuscular volume (MCV)
fL
Hematology: mean corpuscular hemoglobin (MCH)
pg
Hematology: mean corpuscular hemoglobin concentration
mmol/L
Hematology: Platelet count
platelets/mcL
Hematology: RBC
cells/mcL
Hematology: WBC with Differential
cells/mcL
Clinical Chemistry: Sodium
mmol/L
Clinical Chemistry: Potassium
mmol/L
Clinical Chemistry: Chloride
mmol/L
Clinical Chemistry: CO2
mmol/L
Clinical Chemistry: Glucose
mg/dL
Clinical Chemistry: ALT
U/L
Clinical Chemistry: AST
U/L
Clinical Chemistry: Creatine phosphokinase (CPK)
Units/L
Clinical Chemistry: Lactic acid dehydrogenase (LDH)
Units/L
Clinical Chemistry: Albumin
g/L
Clinical Chemistry: Alkaline phosphatase
U/L
Clinical Chemistry: Uric Acid
mmol/L
Clinical Chemistry: Calcium
mmol/L
Clinical Chemistry: Phosphate
U/L
Clinical Chemistry: Total protein
g/L
Clinical Chemistry: Total bilirubin
micro-mol/L
Clinical Chemistry: Blood urea nitrogen
mmol/L
Clinical Chemistry: Creatinine
micro-mol/L
Vital Signs: Temperature
Degree centigrade
Vital Signs: Blood Pressure (Systolic/Diastolic)
mm Hg
Vital Signs: Heart Rate
Beats per minute
Vital Signs: Respiratory Rate
Breaths per minute
Vital Signs: Weight
kg
Vital Signs: Height
cm
Vital Signs: BMI
kg/cm^2
ECG: PR Interval
sec
ECG: QRS Duration
sec
ECG: QT Interval
sec
Urine Pregnancy Test
(If appropriate) If positive, a confirmatory serum test will be performed.

Full Information

First Posted
October 11, 2021
Last Updated
October 23, 2023
Sponsor
B. Braun Medical Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05205486
Brief Title
Pharmacokinetics and Safety of Cefazolin 3gm DUPLEX in Adults
Acronym
3gCefPK
Official Title
A Phase 1, Open-Label, Single-Dose Study to Evaluate the Pharmacokinetics of a Single 3 Gram Dose of Cefazolin in Adult Subjects Weighing >= 120 kg Scheduled for Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 5, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
B. Braun Medical Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is designed to evaluate the pharmacokinetics (PK) of a single 3 gm dose of cefazolin from a DUPLEX container, in adult subjects (weighing >/= 120 kg) scheduled for surgery. Cefazolin will be administered as a 30-minute intravenous (IV) infusion, per cefazolin Package Insert. Five PK samples per subject will be obtained up to 8 hours after dosing. These data will then be assessed by the validated Cefazolin PK Model to verify there are no significant PK changes within this study population.
Detailed Description
This is a Phase 1, open-label, single-dose, multiple-center, study to determine the pharmacokinetics of a single 3 g dose of cefazolin administered as a 30 minute IV infusion prior to surgery in adult subjects weighing >/= 120 kg. Adult subjects will be enrolled in order to ensure at least 12 subjects complete the study. Enrollment will be competitive across the study sites. All subjects will have Screening and baseline evaluations performed to ensure their eligibility for the study The Screening Period is up to 30 days before administration of study drug on Day 1. Study drug will be administrated as an infusion over 30 minutes starting approximately 0.5 hours before surgery begins and following institutional guidelines on Day 1 (day of surgery). Planned surgical procedures may be performed outpatient or inpatient and are expected to last no longer than 3 hours. If the surgery is extended unexpectedly beyond the 3-hour limit, additional doses of study drug are permitted according to institutional guidelines. PK blood sample collection will continue after the administration of an additional dose of cefazolin. Safety in this population will also be assessed. All subjects will have five (5) individual whole blood samples (4 mL each) collected for the estimation of cefazolin concentration in plasma at the following times after the start of the infusion: 0.5 (+/-10 min) end of infusion, 1 h (+/-15 min), 2 h (+/-15 min), 4 h (+/-15 min) and 8 h (+/-15 min). Safety will be assessed by monitoring adverse events (AEs), physical examination, vital signs, and clinical laboratory tests. A follow-up visit will be performed on Day 8 (+/-1 day) for safety assessments. A subject is considered a study completer if he/she has completed all study related procedures through the end of surgery and the required PK sample collections. It is highly preferred that the subjects also participate in the Day 8 (+/-1 day) Safety Follow-up. For subjects who withdraw or are withdrawn before study completion of the study, every effort will be made to perform all Safety Follow up procedures. Any subject who withdraws or is withdrawn before collection of at least 4 of the 5 PK samples will not be consider as a PK completer. If necessary, additional subjects must be enrolled to ensure that there are at least 12 PK completers. On Day 8 (+/-1 day), a Safety follow-up will be conducted. If this is an in-person visit, the following will be performed: vital signs, clinical laboratory tests, examination of the infusion site, review of AEs and concomitant medication. If an in-person visit is not possible, every effort will be made to contact the subject by phone and the subjects will be asked about any AEs and concomitant medication they may have taken.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infections
Keywords
Cephalosporin, antibiotic, infection control, surgical prophylaxis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
This is an open-label, non-randomized pharmacokinetic study. All subjects will be receiving the same study treatment, thus blinding is unnecessary.
Masking
None (Open Label)
Masking Description
This is an open-label, non-randomized pharmacokinetic study. All subjects will be receiving the same study treatment, thus masking is unnecessary.
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cefazolin 3gm Injection
Arm Type
Experimental
Arm Description
Study drug will be administrated as an infusion over 30 minutes starting approximately 0.5 hours before surgery begins and following institutional guidelines on Day 1 (day of surgery). All subjects will have five (5) individual whole blood samples (4 mL each) collected for the estimation of cefazolin concentration in plasma at the following times after the start of the infusion: 0.5 (+/-10 min) end of infusion, 1 h (+/-15 min), 2 h (+/-15 min), 4 h (+/-15 min), and 8 h (+/-15 min).
Intervention Type
Drug
Intervention Name(s)
Cefazolin 3gm for Injection USP and Dextrose Injection USP
Other Intervention Name(s)
Cefazolin 3gm in DUPLEX (50ml)
Intervention Description
Cefazolin 3gm for Injection USP and Dextrose Injection USP in the DUPLEX® Drug Delivery System. Administration will occur once as a 30 minute IV infusion prior to surgery in adult subjects weighing >/= 120 kg
Primary Outcome Measure Information:
Title
Cefazolin plasma concentration following infusion
Description
Concentrations will be determined through analysis of 5 blood samples drawn at 0.5 (end of infusion), 1, 2, 4, and 8 hours after the start of study drug infusion.
Time Frame
8 hours
Secondary Outcome Measure Information:
Title
Number of participants with Treatment-Emergent Adverse Events [Safety] according to Study Protocol
Description
Safety will be assessed by monitoring adverse events (AEs), physical examination, vital signs, and clinical laboratory tests.
Time Frame
2 days with optional visit on Day 8
Title
Hematology: Hemoglobin (Hb)
Description
gm/dL
Time Frame
2 days with optional visit on Day 8
Title
Hematology: Hematocrit (Hct)
Time Frame
2 days with optional visit on Day 8
Title
Hematology: mean corpuscular volume (MCV)
Description
fL
Time Frame
2 days with optional visit on Day 8
Title
Hematology: mean corpuscular hemoglobin (MCH)
Description
pg
Time Frame
2 days with optional visit on Day 8
Title
Hematology: mean corpuscular hemoglobin concentration
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Hematology: Platelet count
Description
platelets/mcL
Time Frame
2 days with optional visit on Day 8
Title
Hematology: RBC
Description
cells/mcL
Time Frame
2 days with optional visit on Day 8
Title
Hematology: WBC with Differential
Description
cells/mcL
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Sodium
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Potassium
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Chloride
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: CO2
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Glucose
Description
mg/dL
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: ALT
Description
U/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: AST
Description
U/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Creatine phosphokinase (CPK)
Description
Units/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Lactic acid dehydrogenase (LDH)
Description
Units/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Albumin
Description
g/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Alkaline phosphatase
Description
U/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Uric Acid
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Calcium
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Phosphate
Description
U/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Total protein
Description
g/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Total bilirubin
Description
micro-mol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Blood urea nitrogen
Description
mmol/L
Time Frame
2 days with optional visit on Day 8
Title
Clinical Chemistry: Creatinine
Description
micro-mol/L
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: Temperature
Description
Degree centigrade
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: Blood Pressure (Systolic/Diastolic)
Description
mm Hg
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: Heart Rate
Description
Beats per minute
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: Respiratory Rate
Description
Breaths per minute
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: Weight
Description
kg
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: Height
Description
cm
Time Frame
2 days with optional visit on Day 8
Title
Vital Signs: BMI
Description
kg/cm^2
Time Frame
2 days with optional visit on Day 8
Title
ECG: PR Interval
Description
sec
Time Frame
2 days
Title
ECG: QRS Duration
Description
sec
Time Frame
2 days
Title
ECG: QT Interval
Description
sec
Time Frame
2 days
Title
Urine Pregnancy Test
Description
(If appropriate) If positive, a confirmatory serum test will be performed.
Time Frame
2 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female aged >/= 18 years; Must weigh >/= 120 kg Able to understand and sign the Informed Consent Form(s) (ICF); Is scheduled for surgery that is expected to last less than 3 hours; Is scheduled for any type of surgery where a single-dose perioperative cefazolin prophylaxis is appropriate. Exclusion Criteria: If female, is pregnant or lactating/breastfeeding. If female that is of childbearing potential and sexually active, and is not using an effective method of birth control, e.g., oral contraceptives, double barrier methods, hormonal injectable or implanted contraceptives, tubal ligation, or have a partner with a vasectomy. Has a history of renal impairment -- Subject has an eGFR of <80 mL/min/1.73m2 performed at Screening as calculated by the following equation: 186 x (Creatinine/88.4)-1.154 x (Age)-0.203 x (0.742 if female) x (1.210 if black) (FDA Guidance for Industry Pharmacokinetics in Patients with Impaired Renal Function) Has a known allergy or hypersensitivity to β lactam/cephalosporin antibiotics, corn products, or dextrose-containing products or solutions, or any of the other ingredients of Cefazolin for Injection United States Pharmacopeia (USP) and Dextrose Injection USP in DUPLEX. Has a result of any laboratory test (or repeat test, if done), obtained as standard of care, that is outside the normal limit of the site's laboratory reference range AND is considered by the investigator to be clinically significant. Has had a recent (within 14 days prior to the planned surgery) administration of cefazolin. Has had administration of any medication (e.g., prescription, herbal, over-the-counter medication[s] or dietary supplements) known to interact with cefazolin within 5 days prior to the study treatment administration. Has a known history of human immunodeficiency virus, hepatitis B, or hepatitis C infection. Has a current history of medical condition(s), which in the opinion of the investigator, would interfere with the evaluation of the study treatment. Has a known history of organ transplant. Has a clinically relevant disease/dysfunction of or a history of severe cardiac, pulmonary or hepatic disease. Is undergoing any cardiovascular procedure including, but not limited to, major cardiac surgery, cardiac catheterizations (including electrophysiology studies), ablations, automatic implantable cardioverter-defibrillator (AICD), and pacemaker. Has received any other investigational drug/device within 30 days prior to the study treatment administration. Has any planned medical intervention or personal event that might interfere with ability to comply with the study requirements. The subject has any condition that, in the opinion of the investigator, would compromise the safety of the subject or the quality of the data. Is unable or unwilling to adhere to the study-specified procedures and restrictions. Is an employee of the Sponsor, Investigator or study-center, has direct involvement in the study or other studies under the direction of that Investigator or study-center, or is a family member of the employees or the Investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Diana Valencia, MD
Phone
610-596-2875
Email
diana.valencia@bbraunusa.com
Facility Information:
Facility Name
IACT Health - Roswell - IACT - HyperCore - PPDS
City
Columbus
State/Province
Georgia
ZIP/Postal Code
31904
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Meghan Roman
Phone
706-321-0495
Facility Name
Hightower Clinical, LLC
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73102
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zac Johnson
Phone
580-677-0243

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
12698406
Citation
Haessler D, Reverdy ME, Neidecker J, Brule P, Ninet J, Lehot JJ. Antibiotic prophylaxis with cefazolin and gentamicin in cardiac surgery for children less than ten kilograms. J Cardiothorac Vasc Anesth. 2003 Apr;17(2):221-5. doi: 10.1053/jcan.2003.51.
Results Reference
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26971263
Citation
Kamath VH, Cheung JP, Mak KC, Wong YW, Cheung WY, Luk KD, Cheung KM. Antimicrobial prophylaxis to prevent surgical site infection in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion: 2 doses versus antibiotics till drain removal. Eur Spine J. 2016 Oct;25(10):3242-3248. doi: 10.1007/s00586-016-4491-7. Epub 2016 Mar 12.
Results Reference
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PubMed Identifier
4201317
Citation
Khan AJ. Clinical and laboratory evaluation of cefazolin: a new cephalosporin antibiotic in pediatric patients. Curr Ther Res Clin Exp. 1973 Oct;15(10):727-33. No abstract available.
Results Reference
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PubMed Identifier
3437384
Citation
Koshida R, Nakashima E, Ichimura F, Nakano O, Watanabe R, Taniguchi N, Tsuji A. Comparative distribution kinetics of cefazolin and tobramycin in children. J Pharmacobiodyn. 1987 Sep;10(9):436-42. doi: 10.1248/bpb1978.10.436.
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PubMed Identifier
7603806
Citation
Lee KR, Ring JC, Leggiadro RJ. Prophylactic antibiotic use in pediatric cardiovascular surgery: a survey of current practice. Pediatr Infect Dis J. 1995 Apr;14(4):267-9. doi: 10.1097/00006454-199504000-00004.
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PubMed Identifier
2644371
Citation
Leggett JE, Fantin B, Ebert S, Totsuka K, Vogelman B, Calame W, Mattie H, Craig WA. Comparative antibiotic dose-effect relations at several dosing intervals in murine pneumonitis and thigh-infection models. J Infect Dis. 1989 Feb;159(2):281-92. doi: 10.1093/infdis/159.2.281.
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PubMed Identifier
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Citation
Maher KO, VanDerElzen K, Bove EL, Mosca RS, Chenoweth CE, Kulik TJ. A retrospective review of three antibiotic prophylaxis regimens for pediatric cardiac surgical patients. Ann Thorac Surg. 2002 Oct;74(4):1195-200. doi: 10.1016/s0003-4975(02)03893-6.
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Citation
Ross S, Rodriguez W, Khan W. The cephalosporin antibiotics in pediatric practice. South Med J. 1977 Jul;70(7):855-61. doi: 10.1097/00007611-197707000-00026.
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Schmitz ML, Blumer JL, Cetnarowski W, Rubino CM. Determination of appropriate weight-based cutoffs for empiric cefazolin dosing using data from a phase 1 pharmacokinetics and safety study of cefazolin administered for surgical prophylaxis in pediatric patients aged 10 to 12 years. Antimicrob Agents Chemother. 2015 Jul;59(7):4173-80. doi: 10.1128/AAC.00082-15. Epub 2015 May 4.
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https://docksci.com/pharmacokinetics-and-tissue-concentrations-of-cefazolin-in-pediatric-patients-un_5f08529a097c472d328b4589.html
Description
Nahata MC, Durrell DE, Ginn-Pease ME, et al. Pharmacokinetics and tissue concentrations of cefazolin in pediatric patients undergoing gastrointestinal surgery. Eur J Drug Metab Pharmacokinet. 1991;16(1):49-52

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Pharmacokinetics and Safety of Cefazolin 3gm DUPLEX in Adults

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