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. 2021 Aug;87(8):3227-3233.
doi: 10.1111/bcp.14739. Epub 2021 Feb 10.

Pharmacokinetics of amoxicillin in obese and nonobese subjects

Ana Luiza P P D P Soares  1   2 , Maiara C Montanha  3 , Conrado D S Alcantara  2 , Sandra R B Silva  2 , Cristina M Kuroda  2 , Sérgio S Yamada  2 , Antônio E Nicacio  4 , Liane Maldaner  5 , Jesui V Visentainer  5 , Caroline F Simões  6 , João Carlos Locatelli  6 , Wendell A Lopes  7 , Josmar Mazucheli  8 , Andrea Diniz  9 , Paulo J P A Paixão  10 , Elza Kimura  2   9
Affiliations
Free article

Pharmacokinetics of amoxicillin in obese and nonobese subjects

Ana Luiza P P D P Soares et al. Br J Clin Pharmacol. 2021 Aug.
Free article

Abstract

Aims: To compare the pharmacokinetics of amoxicillin (AMX) in obese and nonobese subjects, given as single dose 875-mg tablets.

Methods: A prospective, single-centre, open-label, clinical study was carried out involving 10 nonobese and 20 obese subjects given a dose of an AMX 875-mg tablet. Serial blood samples were collected between 0 and 8 hours after administration of AMX and plasma levels were quantified by liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters (PK) were calculated by noncompartmental analysis and means of the 2 groups were compared using Student t-test. Analysis of correlation between covariates and PK was performed using Pearson's correlation coefficient.

Results: Ten nonobese subjects (mean age 30.6 ± 7.12 y; body mass index 21.56 ± 1.95 kg/m2 ) and 20 obese subjects (mean age 34.47 ± 7.03 y; body mass index 33.17 ± 2.38 kg/m2 ) participated in the study. Both maximum concentration (Cmax ; 12.12 ± 4.06 vs. 9.66 ± 2.93 mg/L) and area under the curve (AUC)0-inf (34.18 ± 12.94 mg.h/L vs. 26.88 ± 9.24 mg.h/L) were slightly higher in nonobese than in obese subjects, respectively, but differences were not significant. The volume of distribution (V/F) parameter was statistically significantly higher in obese compared to nonobese patients (44.20 ± 17.85 L vs. 27.57 ± 12.96 L). Statistically significant correlations were observed for several weight metrics vs. AUC, Cmax , V/F and clearance, and for creatinine clearance vs. AUC, Cmax and clearance.

Conclusion: In obese subjects, the main altered PK was V/F as a consequence of greater body weight. This may result in antibiotic treatment failure if standard therapeutic regimens are administered.

Keywords: amoxicillin; obesity; pharmacokinetics.

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References

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