Pharmacokinetics Study of Cefazolin in Hemodialysis (CEFAZODIAL)
In chronic hemodialysis patients, bacteremia is most commonly caused by dialysis catheter infections. It is estimated that the vast majority (52-84%) of these infections are due to Gram-positive cocci, particularly Staphylococcus aureus (21-43%). Penicillin M (oxacillin and cloxacillin in France) is the reference beta-lactam for the treatment of invasive methicillin-sensitive S. aureus (MSSA) infections, but has not shown a prognostic benefit in large retrospective cohorts comparing penicillin M and cefazolin, at the expense of more frequent adverse events. Dosage in the chronic hemodialysis population is unclear because it is based on old studies.
• Subjects aged 18 or over
• On chronic intermittent dialysis
• With a stated indication for initiation of cefazolin either:
‣ For probabilistic treatment of a clinical presentation suggestive of MSSA infection
⁃ for treatment of Gram-positive cocci bacteremia
• With the possibility of taking peripheral blood samples or samples from the dialysis machine until the next dialysis session at 48 hours.
• Included within a maximum of one week after the first cefazolin injection.
• Affiliated with French social security
• Having signed an informed consent form