Treatment of bacterial infections in obese adult patients: how to appropriately manage antimicrobial dosage
Treatment of bacterial infections in obese adult patients: how to appropriately manage antimicrobial dosage
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DOI：
10.1016/j.coph.2015.06.004
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发表时间：
2015-10-01
影响因子：
4
通讯作者：
Pai, Manjunath P.
中科院分区：
文献类型：
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作者：
Pai, Manjunath P.
肥胖患者可能需要更大的初始抗菌剂量，但维持剂量选择的最佳方法是有限的。肥胖患者的关键药代动力学系统参数较高，但通常与总体重（TBW）不成比例。在肥胖患者中，固定剂量选择有暴露下的风险，而基于tbw的剂量有过度暴露的风险。替代的体型描述符限制了肥胖患者的过量用药，这对于治疗指数较窄的抗菌剂至关重要。在缺乏治疗药物监测的情况下，肥胖患者抗微生物药物的维持剂量计算具有挑战性。基于估计肾功能的肥胖患者抗菌药物剂量选择方法是一种较少但临床上适用的替代方法。
Obese patients may require bigger initial antimicrobial doses but the optimal approach to maintenance dose selection is limited. Key pharmacokinetic system parameters are higher in obese patients but often not proportional to total body weight (TBW). Fixed-dose selection risks under exposure while TBW-based dosing risks over exposure in obese patients. Alternate body size descriptors limit overdosing in obesity that is vital for antimicrobials with a narrow therapeutic index. Maintenance dose calculation of antimicrobials in obese patients is challenging in the absence of therapeutic drug monitoring. Approaches to antimicrobial dose selection in obesity based on estimated kidney function serves as a lesser but clinically applicable alternative.