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[Anti-infective treatment in obesity-"just double it?"]

P Simon1

  • 1Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland. Philipp.Simon@medizin.uni-leipzig.de.

Der Anaesthesist
|June 4, 2020
PubMed

Insights

Antibiotic dosing in obese patients requires careful consideration. Measuring antibiotic concentrations in target tissues using microdialysis is essential for effective anti-infective therapy in this population.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Adequate antibiotic therapy is critical for successful treatment of infections.
  • Antibiotic dosing, duration, and choice are key factors in efficacy.
  • Obesity impacts antibiotic pharmacokinetics, potentially leading to underdosing with standard regimens.

Purpose of the Study:

  • To highlight the necessity of measuring antibiotic concentrations in obese patients.
  • To emphasize the importance of target tissue concentration measurements.
  • To introduce microdialysis as a suitable technique for continuous tissue concentration monitoring.

Main Methods:

  • Systematic concentration measurements in obese patients.
  • Pharmacokinetic analysis considering tissue distribution.
  • Application of microdialysis for continuous in vivo measurements.

Main Results:

  • Obesity alters antibiotic pharmacokinetics, risking underdosing.
  • Significant pharmacokinetic differences exist between plasma and interstitial fluid for various antibiotics.
  • Microdialysis enables continuous monitoring of antibiotic concentrations in target tissues.

Conclusions:

  • Weight-independent dosing may be inadequate for obese patients.
  • Target tissue concentration measurement is crucial for optimizing antibiotic therapy.
  • Microdialysis is an effective method for assessing antibiotic pharmacokinetics in obese individuals.
Keywords:
AntibioticsDosingMicrodialysisPharmacokineticsTarget tissue

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