Paracetamol and Cefazolin Pharmacokinetics in Normal Weight and Overweight Children (TISSUE)
Pharmacokinetic evaluations will be conducted to characterize the cefazolin plasma concentration-time profile, cefazolin penetration into subcutaneous adipose tissue, and paracetamol metabolization as assessed through blood sampling. The study population consists of children aged 2 to 15 years with either normal weight or overweight. All participants are admitted for a minor elective surgical procedure and will receive paracetamol and/or cefazolin as part of standard perioperative care.
During the procedure, multiple blood and tissue-fluid samples will be collected to quantify paracetamol and cefazolin concentrations in the bloodstream, as well as cefazolin concentrations in subcutaneous adipose tissue. The study aims to characterize drug concentration-time profiles in blood (paracetamol), plasma (cefazolin), and adipose tissue (cefazolin), and to compare these pharmacokinetic parameters between normal-weight and overweight children.
These data are essential to determine whether standard dosing regimens provide adequate drug exposure across different weight categories. Previous research indicates that achieving specific target concentrations in blood and tissue is necessary for optimal therapeutic effect, yet uncertainty remains regarding appropriate dosing in overweight children.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Pieter De Cock, Prof. Apr
- Phone Number: +32 9 332 29 69
- Email: pieter.decock@uzgent.be
Study Contact Backup
- Name: Annemie Bauters, MD.
- Phone Number: + 32 9 332 18 83
- Email: Annemie.Bauters@UGent.be
Study Locations
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-
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Ghent, Belgium, 9000
- Recruiting
- Ghent University Hospital, Ghent
-
Contact:
- Anca Amza
- Phone Number: +32 9 332 18 83
- Email: anca.amza@uzgent.be
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Principal Investigator:
- Pieter De Cock, Prof. Apr.
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patient admitted to the operating room for minor elective surgery
- Patients undergoing general anesthesia for minor elective surgery
- Patient age: children from 2 years to 15 years
- Patients receiving cefazolin or paracetamol according to the standard procedure
- Intra-arterial (preferred) or intravenous access available for blood sampling
- BMI
Exclusion Criteria:
- Personal or family history of excessive bleeding
- Pre-existing coagulopathy and/or thrombocytopenia
- No catheter available for blood sampling
- Absence of parental consent
- Known allergy to one of the components of the study
- Pregnancy
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Standard of Care Paracetamol or Cefazolin treatment in children with normal weight
|
Prophylactic Cefazolin treatment per standard-of-care
Other Names:
Preoperative dose of paracetamol, as per standard-of-care
Other Names:
|
|
Standard of Care Paracetamol or Cefazolin treatment in children with overweight
|
Prophylactic Cefazolin treatment per standard-of-care
Other Names:
Preoperative dose of paracetamol, as per standard-of-care
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Blood concentrations of paracetamol and its metabolites
Time Frame: Blood VAMS samples collected at day0 (D0): 1) before infusion(D0): predose , 2) 5 minutes after infusion (D0), 3) 5-120 minutes after infusion (D0): distribution phase, 4) 2 hours after infusion (D0), 5) 3-5 hours after infusion (D0): elimination phase
|
Blood concentrations (mg/L) of paracetamol and its metabolites: glucuronide-, sulfate-, cysteine- and mercapturate-conjugates after a single intravenous perfusion of paracetamol.
Samples collected with Volumetric Absorptive Microsampling (VAMS).
|
Blood VAMS samples collected at day0 (D0): 1) before infusion(D0): predose , 2) 5 minutes after infusion (D0), 3) 5-120 minutes after infusion (D0): distribution phase, 4) 2 hours after infusion (D0), 5) 3-5 hours after infusion (D0): elimination phase
|
|
Cefazolin plasma and tissue concentrations
Time Frame: At D0 sampled: Plasma: 1) predose, 2) 5 minutes after infusion, 3) 5-120 minutes, 4) 2 hours, 5) 3-5 hours; Microdialysis: 1) baseline (-30 - 0 minutes), 2) first 2 hours after dosing (every 30 minutes a sample), 3) next 3 hours (every 1 hour a sample)
|
Plasma concentrations (mg/L) are stored in heparine blood tubes.
Tissue concentrations (mg/L) are collected with a microdialysis device and stored in specific microdialysis vials.
|
At D0 sampled: Plasma: 1) predose, 2) 5 minutes after infusion, 3) 5-120 minutes, 4) 2 hours, 5) 3-5 hours; Microdialysis: 1) baseline (-30 - 0 minutes), 2) first 2 hours after dosing (every 30 minutes a sample), 3) next 3 hours (every 1 hour a sample)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Biomarkers values: enzymes
Time Frame: Blood was collected togheter with blood sample 4 for cefazolin concentrations, 2 hours after drug administration on day0 (D0)
|
Determination of the presence and concentration of enzymes based on the values Aspartate aminotransferase (AST; U/L), Alanine aminotransferase (ALT; U/L), and Gamma-Glutamyl transpeptidase (GGT; U/L).
|
Blood was collected togheter with blood sample 4 for cefazolin concentrations, 2 hours after drug administration on day0 (D0)
|
|
Biomarker values: proteins
Time Frame: Blood was collected togheter with blood sample 4 for cefazolin concentrations, 2 hours after drug administration on day0 (D0)
|
Determination of the presence and concentration of proteins based on the values Bilirubin (total & direct; g/L), serum creatinine (SCR; g/L), total protein (g/L), Albumin (g/L), and C-reactive protein (CRP; g/L).
|
Blood was collected togheter with blood sample 4 for cefazolin concentrations, 2 hours after drug administration on day0 (D0)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Anca Amza, Ghent University Hospital and Ghent Univeristy
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Nutrition Disorders
- Overnutrition
- Body Weight
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Overweight
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Anilides
- Amides
- Aniline Compounds
- Amines
- Acetanilides
- beta-Lactams
- Lactams
- Cephalosporins
- Thiazines
- Acetaminophen
- Cefazolin
- Pharmaceutical Preparations
Other Study ID Numbers
Other Study ID Numbers
- ONZ-2023-0432
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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