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Dosing in Obese Critically Ill Patients

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Antibiotic Pharmacokinetic/Pharmacodynamic Considerations in the Critically Ill

Abstract

As the prevalence of obesity continues to rise significantly worldwide, an increasing number of overweight patients are expected to present to hospital with various pathological conditions. In particular, obese patients are at risk for acquiring infections. When facing life-threatening infections in critically ill patients, careful antibiotic dose adjustment based on pharmacokinetic/pharmacodynamic (PK/PD) considerations is necessary because hospital-related infections are often caused by pathogens with decreased susceptibility (as compared to community isolates) and drug handling is altered in this patient population. Antibiotic PK may be even further altered in obese critically ill patients. In this chapter, we will explore why obese patients may be more susceptible to infections than lean individuals, what the possible PK changes are due to obesity per se, and how to use PK principles to optimize antibiotic dosing strategies in this patient population.

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Authors and Affiliations

  1. Department of Infectious Diseases, CUB-Erasme, Université Libre de Bruxelles, Brussels, Belgium

    Maya Hites

  2. Department of Intensive Care, CUB-Erasme, Université Libre de Bruxelles, Brussels, Belgium

    Fabio Silvio Taccone

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  1. Maya Hites
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  2. Fabio Silvio Taccone
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Correspondence to Fabio Silvio Taccone .

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Editors and Affiliations

  1. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

    Andrew A. Udy

  2. Burns, Trauma and Critical Care Research Centre, The University of Queensland, Herston, Queensland, Australia

    Jason A. Roberts

  3. Burns, Trauma and Critical Care Research Centre, The University of Queensland, Herston, Queensland, Australia

    Jeffrey Lipman

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Hites, M., Taccone, F.S. (2018). Dosing in Obese Critically Ill Patients. In: Udy, A., Roberts, J., Lipman, J. (eds) Antibiotic Pharmacokinetic/Pharmacodynamic Considerations in the Critically Ill. Adis, Singapore. https://doi.org/10.1007/978-981-10-5336-8_4

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