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Pharmacokinetics of Clindamycin in Obese and Nonobese Children

Michael J Smith1,2, Daniel Gonzalez3, Jennifer L Goldman4

  • 1Division of Pediatric Infectious Diseases, University of Louisville, Louisville, Kentucky, USA mjsmit22@louisville.edu.

Antimicrobial Agents and Chemotherapy
|February 1, 2017
PubMed

Insights

Total body weight (TBW) is the best metric for dosing clindamycin in children. This pharmacokinetic analysis found TBW-based dosing effective for both obese and nonobese pediatric patients.

Area of Science:

  • Pediatric Pharmacology
  • Antibiotic Dosing
  • Obesity Research

Background:

  • Limited pharmacokinetic data exists for obese children.
  • Clindamycin dosing may need adjustment in obese children due to lipophilicity.

Purpose of the Study:

  • To conduct a population pharmacokinetic analysis of clindamycin in children.
  • To determine the most robust measure of body size for clindamycin dosing in pediatric patients, including those who are obese.

Main Methods:

  • Population pharmacokinetic analysis of clindamycin using data from 220 children (76 obese).
  • Evaluated total body weight (TBW) and other metrics as measures of body size.
  • Developed a model incorporating TBW and postmenstrual age (PMA) for clearance (CL) and TBW, albumin (ALB), and alpha-1 acid glycoprotein (AAG) for volume of distribution (V).

Main Results:

  • Total body weight (TBW) was the most robust measure of body size.
  • The final population PK model included TBW and PMA for CL, and TBW, ALB, and AAG for V.
  • Obesity status did not significantly impact model parameters after accounting for TBW.

Conclusions:

  • Total body weight (TBW)-based dosing is supported for clindamycin in both obese and nonobese children.
  • The developed pharmacokinetic model can aid in optimizing clindamycin dosing in pediatric populations.

Keywords:
antibioticschildrenclindamycinobesitypharmacokinetics

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