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Antibiotic therapy ofpneumonia in the obese

patient:dosing and delivery

Muhammad AinulYain

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Purpose of review

Obesity has been shown to be

associated with antibioticunderdosing and treatment failure.

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Recent Findings

Obesity is associated with severalalterations in antibioticpharmacokinetics andpharmacodynamics, includingincreases in the antibiotic volume ofdistribution and clearance.

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Summary

Recognizing obesity-relatedpharmacokinetic andpharmacodynamic alterations is

important in treating obese patientswith pneumonia

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Introduction

Obesity is associated with several alterationsin

antibiotic pharmacokinetics and

pharmacodynamics. Data on antibiotic dosing for pneumonia in

obese patients are limited and come mainlyfrom observational studies.

Obesity should be considered when dosing ofb-lactams, vancomycin, or aminoglycosidesfor the management of pneumonia.

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RIS FA!"#RS F#R $#SI%&

!'A%&(S I% #)(S( PA"I(%"S

Absorption

Distribution

etabolism

Renal clearance !harmacodynamic consideration

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A%"I)I#"I! $#SI%& A%$ $(*I+(RYI%

#)(S( PA"I(%"S " # lactams

!iperacillin and tazobactam

$ephalosoprins

$arbapenems %luoro&uinolones

acrolides

Aminoglycosides

'ancomycin

(inezolid

!olymi)ins Antifungal agents

*euraminidase inhibitors

*ebulized antibiotics

Antibiotic dosing after bariatric+urgery

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F,",R( $IR(!"I#%S !#%!*,SI#%

Data regarding the dosing of antibiotics inobese patients with pneumonia are limited.

he correlation between plasma antibiotic

concen-trations and lung tissue levels inobese patients is lacking and warrantsfurther study.

%urther studies on the eect of dosing of

antibiotics in obese patients with pneumoniaon patient-centered out-comes, includingrecovery, relapse, and mortality, are needed

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Mercie--