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Related Experiment Videos

Antimicrobial dosing in obese patients

R Wurtz1, G Itokazu, K Rodvold

  • 1Department of Medicine, Evanston Hospital, Illinois 60201, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 1, 1997
PubMed
Summary
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Dosage adjustments for antimicrobials in obesity are rarely made. Research suggests specific weight correction factors for certain drug classes, but more studies are needed for optimal antimicrobial dosing in obese patients.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Obesity Medicine

Background:

  • Weight-based dosing is common for some drugs but not most antimicrobials.
  • Obesity presents unique pharmacokinetic challenges, yet its impact on antimicrobial efficacy is largely unknown.
  • Current empirical methods for antimicrobial dosing in obesity lack robust validation.

Purpose of the Study:

  • To review the English-language literature on antimicrobial pharmacokinetics and dosing in obesity.
  • To evaluate the impact of obesity on antimicrobial drug disposition and clinical outcomes.
  • To identify evidence-based approaches for adjusting antimicrobial dosages in obese individuals.

Main Methods:

  • Systematic literature review of English-language studies on antimicrobial pharmacokinetics and obesity.

Related Experiment Videos

  • Analysis of pharmacokinetic consequences of obesity relevant to drug dosing.
  • Evaluation of existing empirical formulas and clinical data for weight-based antimicrobial dosing.

    • Main Results:

    • The precise effect of obesity on the pharmacokinetics and efficacy of most antimicrobials remains undetermined.
    • An empirical approach uses the Devine formula with a dosing weight correction factor (DWCF) for hydrophilic antibiotics, but lacks confirmation for beta-lactams.
    • Clinical data suggest DWCFs of approximately 0.40 for aminoglycosides and 0.45 for quinolones.

    Conclusions:

    • Weight-related antimicrobial dosage adjustments in obesity require further research and validation.
    • Specific weight correction factors may be applicable to certain antimicrobial classes like aminoglycosides and quinolones.
    • Therapeutic drug monitoring, including serum concentrations, is crucial for antimicrobials with a narrow therapeutic index in obese patients.