Dosing of antifungal agents in obese people

Area of Science:

• Pharmacology and Infectious Diseases
• Clinical Pharmacy and Therapeutics
• Obesity Medicine

Background:

• Obesity is a global health issue, increasing hospitalization risks due to comorbidities.
• Limited pharmacokinetic data exist for antifungal agents in obese populations, often excluded from studies.
• Systemic antifungal therapy for invasive candidiasis faces high failure rates, highlighting the need for dose optimization.

Purpose of the Study:

• To review current pharmacokinetic data for antifungal agents in obese individuals.
• To identify antifungals requiring dose adjustments based on body weight.
• To emphasize the importance of individualized dosing strategies for obese patients.

Main Methods:

• Literature review of pharmacokinetic studies involving antifungal agents and obesity.
• Analysis of dosing recommendations for specific antifungal drugs (e.g., fluconazole, posaconazole).
• Synthesis of evidence regarding body weight's impact on antifungal efficacy and safety.

Main Results:

• Some antifungals, like fluconazole, necessitate dosing based on total body weight.
• Other antifungals, such as posaconazole, may not require dose adjustment for increased body weight.
• Significant gaps in data exist for many antifungal agents concerning obesity.

Conclusions:

• Antifungal drug dosing in obesity requires careful consideration and individual assessment.
• Current evidence suggests differential dosing strategies based on specific agents and body weight.
• Further research is essential to establish definitive dosing guidelines for antifungals in obese patients.