Prospective, Controlled Study of Acyclovir Pharmacokinetics in Obese Patients
| Autor: | Michael Sweet, Michael Craig, Aaron Cumpston, Douglas Slain, Sijin Wen, R. Brigg Turner, William Petros, Frank Briggs, Mehdi Hamadani |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty 030106 microbiology Population Ideal Body Weight Urology Acyclovir Clinical Therapeutics Body weight Body Mass Index 03 medical and health sciences Pharmacokinetics Humans Medicine Drug Dosage Calculations Pharmacology (medical) Obesity Prospective Studies Dosing Prospective cohort study education Pharmacology education.field_of_study business.industry Liter Middle Aged medicine.disease Surgery Infectious Diseases Female business Body mass index |
| Zdroj: | Antimicrobial Agents and Chemotherapy. 60:1830-1833 |
| ISSN: | 1098-6596 0066-4804 |
| DOI: | 10.1128/aac.02010-15 |
| Popis: | The current recommendations for intravenous (i.v.) acyclovir dosing in obese patients suggest using ideal body weight (IBW) rather than total body weight (TBW). To our knowledge, no pharmacokinetic analysis has validated this recommendation. This single-dose pharmacokinetic study was conducted in an inpatient oncology population. Enrollment was conducted by 1:1 matching of obese patients (>190% of IBW) to normal-weight patients (80 to 120% of IBW). All patients received a single dose of i.v. acyclovir, 5 mg/kg, infused over 60 min. Consistent with current recommendations, IBW was used for obese patients and TBW for normal-weight patients. Serial plasma concentrations were obtained and compared. Seven obese and seven normal-weight patients were enrolled, with mean body mass indexes of 45.0 and 22.5 kg/m 2 , respectively. Systemic clearance was substantially higher in the obese than normal-weight patients (mean, 19.4 ± 5.3 versus 14.3 ± 5.4 liters/h; P = 0.047). Area under the concentration-time curve was lower in the obese patients (15.2 ± 2.9 versus 24.0 ± 9.4 mg · h/liter; P = 0.011), as was maximum concentration (5.8 ± 0.9 versus 8.2 ± 1.3 mg/liter; P = 0.031). Utilization of IBW for dose calculation of i.v. acyclovir in obese patients leads to lower systemic exposure than dosing by TBW in normal-weight patients. While not directly evaluated in this study, utilization of an adjusted body weight for dose determination appears to more closely approximate the exposure seen in normal-weight patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01714180.) |
| Databáze: | OpenAIRE |
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