What is it about?
We provide an overall critical review of the available data regarding PK and formulate dosing recommendations in both critically ill and noncritically ill adult patients with significant obesity. We include specific dosing recommendations for 34 antimicrobials based on 121 articles of the 2336 identified by our search strategy.
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Why is it important?
Much of the published clinical and PK evidence to date consists of small patient populations and are retrospective with, not infrequently, heterogeneous results that in some cases are contradictory. In the last 10 years, additional antimicrobial PK/PD and clinical data encompassing prolonged infusion strategies and examination of critically ill populations have emerged to inform antimicrobial dosing in obesity.
Perspectives
We found that obesity dosing differs even within antibiotic classes, making class extrapolations difficult when data is sparse or lacking. Multiple concomitant factors often occur with obesity, such as critical illness or organ impairment, which further complicates dosing in this population. TDM will be important in individualizing dosing decisions in special populations.
Dr Lina Meng
Southbay Oncology Hematology Partners
Read the Original
This page is a summary of: Comprehensive Guidance for Antibiotic Dosing in Obese Adults, Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy, October 2017, Wiley,
DOI: 10.1002/phar.2023.
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