β-Lactam Antibiotics in Obese Adults: A Review of Population Pharmacokinetic Analyses

Obesity is becoming more prevalent, and it significantly alters drug pharmacokinetics (PK), potentially impacting the efficacy and safety of β-lactam antibiotics. Population pharmacokinetic (popPK) modeling plays a crucial role in optimizing dosing strategies, yet there is variability in how these models account for obesity-related physiological changes. This review aims to synthesize published popPK studies on β-lactams in obese populations, highlighting key findings and modeling approaches. A literature review was conducted to identify popPK studies evaluating β-lactam antibiotics in obese individuals. Relevant databases were searched for studies reporting PK parameters, covariates, and dosing recommendations. A total of 24 studies met the predefined selection criteria. The majority employed two-compartment models with creatinine clearance (CL_CR) and total body weight (TBW) as the most common covariates for clearance (CL) and volume of distribution (V_d). Estimated PK parameters differed within the same β-lactam, which indicates that obesity influences the PK of β-lactams, though the extent of its impact differs based on the specific drug, patient characteristics, and selected covariates. This review highlights the key aspects of popPK models in obese populations treated with β-lactams. Despite the growing prevalence of obesity, its influence on β-lactam antibiotics remains uncertain.