Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
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Review

Volume 6, Number 4, August 2014, pages 227-233


Pharmacokinetic Changes and Dosing Modification of Aminoglycosides in Critically Ill Obese Patients: A Literature Review

Table

Table 1. Summary, in Chronological Order, of Studies on Aminoglycoside Pharmacokinetics and Dose Adjustment in Obesity
 
Author, yearAntibiotic studiedMain findings
ABW: adjusted body weight; ClCr: creatinine clearance; DWCF: dosing weight correction factor; IBW: ideal body weight; TBW: total body weight; Vd: volume of distribution.
Schwartz et al, 1978 [1]Gentamicin, tobramycinVd in obese subjects closely approximates Vd in normal subjects when using the formula: ABW = IBW + 0.4 × (TBW - IBW)
Blouin et al, 1979 [2]TobramycinTobramycin loading dose based on ABW = IBW + 0.58 × (TBW - IBW)
Korsager, 1980 [4]GentamicinGentamicin uptake in adipose tissue = 43.7% of uptake in total body mass of normal-weight patients
Bauer et al, 1980 [3]AmikacinAmikacin loading dose based on ABW = IBW + 0.38 × (TBW - IBW)
Bauer et al, 1983 [5]Gentamicin, tobramycin, amikacinLoading dose based on ABW = IBW + 0.4 × (TBW - IBW)
Leader et al, 1994 [11]GentamicinInitial dose based on calculation of ClCr by Cockroft equation with IBW + 0.4 × (TBW - IBW)
Traynor et al, 1995 [8]TobramycinThe TBW/IBW ratio predicts Vd.
For patients with TBW/IBW ratio ≥ 1.25, doses based on ABW = IBW + 0.43 × (TBW - IBW)
Wurtz et al, 1997 [10]AminoglycosidesDWCF = 0.4, therefore ABW = IBW + 0.4 × (TBW - IBW)
Pai et al, 2007 [12]AminoglycosidesDosing of aminoglycosides should be based on ABW.