Updated antimicrobial dosing recommendations for obese patients.

Area of Science:

• Pharmacology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Rising global obesity rates present unique challenges in clinical practice.
• Obesity-related physiological changes significantly impact drug pharmacokinetics (PK) and pharmacodynamics (PD).
• Standard antimicrobial dosing may be suboptimal in obese individuals, risking therapeutic failure or adverse events.

Purpose of the Study:

• To comprehensively review and critically assess antimicrobial dosing strategies for obese adult patients.
• To consolidate available pharmacokinetic and pharmacodynamic data for various antimicrobial classes in obesity.
• To address the challenge of finding clear and consistent dosing guidelines for this population.

Main Methods:

• Systematic literature review of pharmacokinetic (PK) and pharmacodynamic (PD) data.
• Critical assessment of published studies on antimicrobial dosing in obese adults.
• Inclusion of data on antibiotics, antifungals, antivirals, and antituberculosis drugs.

Main Results:

• Obesity significantly alters antimicrobial absorption, distribution, metabolism, and excretion.
• Evidence supports modified dosing regimens for many antimicrobials in obese patients.
• Extended infusion strategies and weight-based dosing are frequently recommended.

Conclusions:

• Optimized antimicrobial dosing is crucial for effective treatment in obese patients.
• Further research is needed to refine dosing guidelines across all antimicrobial classes.
• Clinicians should carefully consider patient weight and PK/PD alterations when prescribing antimicrobials to obese individuals.