Ceftazidime dosing in obese patients: is it time for more?

IF 3.9 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Expert Opinion on Drug Metabolism & Toxicology Pub Date : 2022-04-03 DOI:10.1080/17425255.2022.2080052

Cornélie Fanton D'Andon, Patricia Correia, J. Rigaill, B. Kably, Sophie Périnel-Ragey, M. Launay

{"title":"Ceftazidime dosing in obese patients: is it time for more?","authors":"Cornélie Fanton D'Andon, Patricia Correia, J. Rigaill, B. Kably, Sophie Périnel-Ragey, M. Launay","doi":"10.1080/17425255.2022.2080052","DOIUrl":null,"url":null,"abstract":"ABSTRACT Introduction Ceftazidime is used for the treatment of many bacterial infections, including severe P. aeruginosa infections. Like other beta-lactams, inter-individual variability in ceftazidime pharmacokinetics has been described. Due to its related pathophysiological modifications, obesity might influence ceftazidime pharmacokinetics. Areas covered The objective of this review is to assess the current state of knowledge about the impact of obesity on ceftazidime treatment. A literature search was conducted on PubMed-MEDLINE (2016–2021) to retrieve pharmacokinetic studies published in English, matching the terms ‘ceftazidime’ AND ‘pharmacokinetics.’ Expert opinion The impact of obesity on pharmacokinetics is generally poorly known, mainly because obese patients are often excluded from clinical studies. However, the published literature clearly shows that obese patients have significantly lower ceftazidime concentrations. This could be explained by increased volume of distribution and clearance. This low exposure represents a major factor of therapeutic failure, potentially fatal for critically ill patients. While further studies would be useful to better assess the magnitude and understanding of this variability, the use of higher doses of ceftazidime is needed in obese patients. Moreover, therapeutic drug monitoring for dose adaptation is of major interest for these patients, as the efficacy of ceftazidime seems to be directly related to its plasma concentration.","PeriodicalId":12250,"journal":{"name":"Expert Opinion on Drug Metabolism & Toxicology","volume":"18 1","pages":"277 - 284"},"PeriodicalIF":3.9000,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Opinion on Drug Metabolism & Toxicology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17425255.2022.2080052","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}

引用次数: 1

Abstract

ABSTRACT Introduction Ceftazidime is used for the treatment of many bacterial infections, including severe P. aeruginosa infections. Like other beta-lactams, inter-individual variability in ceftazidime pharmacokinetics has been described. Due to its related pathophysiological modifications, obesity might influence ceftazidime pharmacokinetics. Areas covered The objective of this review is to assess the current state of knowledge about the impact of obesity on ceftazidime treatment. A literature search was conducted on PubMed-MEDLINE (2016–2021) to retrieve pharmacokinetic studies published in English, matching the terms ‘ceftazidime’ AND ‘pharmacokinetics.’ Expert opinion The impact of obesity on pharmacokinetics is generally poorly known, mainly because obese patients are often excluded from clinical studies. However, the published literature clearly shows that obese patients have significantly lower ceftazidime concentrations. This could be explained by increased volume of distribution and clearance. This low exposure represents a major factor of therapeutic failure, potentially fatal for critically ill patients. While further studies would be useful to better assess the magnitude and understanding of this variability, the use of higher doses of ceftazidime is needed in obese patients. Moreover, therapeutic drug monitoring for dose adaptation is of major interest for these patients, as the efficacy of ceftazidime seems to be directly related to its plasma concentration.

查看原文本刊更多论文

肥胖患者服用头孢他啶:是时候增加剂量了吗?

头孢他啶用于治疗多种细菌感染，包括严重的铜绿假单胞菌感染。像其他β -内酰胺类药物一样，头孢他啶药代动力学的个体差异性已经被描述。由于其相关的病理生理改变，肥胖可能影响头孢他啶的药代动力学。本综述的目的是评估目前关于肥胖对头孢他啶治疗影响的知识状况。在PubMed-MEDLINE(2016-2021)上进行文献检索，检索已发表的英文药代动力学研究，匹配术语“头孢他啶”和“药代动力学”。专家意见肥胖对药代动力学的影响通常知之甚少，主要是因为肥胖患者经常被排除在临床研究之外。然而，已发表的文献清楚地表明，肥胖患者的头孢他啶浓度明显较低。这可能是由于分销和清仓量的增加。这种低暴露是治疗失败的一个主要因素，对危重病人来说可能是致命的。虽然进一步的研究将有助于更好地评估这种变异性的程度和理解，但肥胖患者需要使用更高剂量的头孢他啶。此外，治疗药物监测剂量适应是这些患者的主要兴趣，因为头孢他啶的疗效似乎与其血浆浓度直接相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Expert Opinion on Drug Metabolism & Toxicology 医学-生化与分子生物学

CiteScore

7.90

自引率

2.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Opinion on Drug Metabolism & Toxicology (ISSN 1742-5255 [print], 1744-7607 [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of ADME-Tox. Each article is structured to incorporate the author’s own expert opinion on the scope for future development. The Editors welcome: Reviews covering metabolic, pharmacokinetic and toxicological issues relating to specific drugs, drug-drug interactions, drug classes or their use in specific populations; issues relating to enzymes involved in the metabolism, disposition and excretion of drugs; techniques involved in the study of drug metabolism and toxicology; novel technologies for obtaining ADME-Tox data. Drug Evaluations reviewing the clinical, toxicological and pharmacokinetic data on a particular drug. The audience consists of scientists and managers in the pharmaceutical industry, pharmacologists, clinical toxicologists and related professionals.