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. 2024 May 2;68(5):e0171923.
doi: 10.1128/aac.01719-23. Epub 2024 Mar 25.

Updated antimicrobial dosing recommendations for obese patients

Ana Castro-Balado #  1   2 , Iria Varela-Rey #  1   2 , Beatriz Mejuto  1 , Cristina Mondelo-García  1   2 , Irene Zarra-Ferro  1   2 , Teresa Rodríguez-Jato  1   2 , Anxo Fernández-Ferreiro  1   2
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Updated antimicrobial dosing recommendations for obese patients

Ana Castro-Balado et al. Antimicrob Agents Chemother. .

Abstract

The prevalence of obesity has increased considerably in the last few decades. Pathophysiological changes in obese patients lead to pharmacokinetic (PK) and pharmacodynamic (PD) alterations that can condition the correct exposure to antimicrobials if standard dosages are used. Inadequate dosing in obese patients can lead to toxicity or therapeutic failure. In recent years, additional antimicrobial PK/PD data, extended infusion strategies, and studies in critically ill patients have made it possible to obtain data to provide a better dosage in obese patients. Despite this, it is usually difficult to find information on drug dosing in this population, which is sometimes contradictory. This is a comprehensive review of the dosing of different types of antimicrobials (antibiotics, antifungals, antivirals, and antituberculosis drugs) in obese patients, where the literature on PK and possible dosing strategies in obese adults was critically assessed.

Keywords: antimicrobial; dosing; obesity; pharmacodynamics; pharmacokinetics; weight.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

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Fig 1
Physiological changes in obesity and its corresponding influence on PK parameters. Image was created with BioRender.com.
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