|
1
|
Castro-Balado A, Varela-Rey I, Mejuto B, Mondelo-García C, Zarra-Ferro I, Rodríguez-Jato T, Fernández-Ferreiro A. Updated antimicrobial dosing recommendations for obese patients. Antimicrob Agents Chemother 2024; 68:e0171923. [PMID: 38526051 PMCID: PMC11064535 DOI: 10.1128/aac.01719-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
The prevalence of obesity has increased considerably in the last few decades. Pathophysiological changes in obese patients lead to pharmacokinetic (PK) and pharmacodynamic (PD) alterations that can condition the correct exposure to antimicrobials if standard dosages are used. Inadequate dosing in obese patients can lead to toxicity or therapeutic failure. In recent years, additional antimicrobial PK/PD data, extended infusion strategies, and studies in critically ill patients have made it possible to obtain data to provide a better dosage in obese patients. Despite this, it is usually difficult to find information on drug dosing in this population, which is sometimes contradictory. This is a comprehensive review of the dosing of different types of antimicrobials (antibiotics, antifungals, antivirals, and antituberculosis drugs) in obese patients, where the literature on PK and possible dosing strategies in obese adults was critically assessed.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Iria Varela-Rey
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Beatriz Mejuto
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Teresa Rodríguez-Jato
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| |
Collapse
|
|
2
|
Bajaber AN, Elrggal M, Organji WF, Sulaimani MA, Refai RM, Alsaedi A, Alzamzami SH, Hawsawi FB, Alnefaie ST, Alsulaimani AA, Alharbi A, Alnuhait M, Alshammari AS, Aldarhami A, Sharaf SE. Evaluating Adherence to Therapeutic Drug Monitoring Guidelines for Gentamicin in Neonatal Care: A Retrospective Study at the Maternity and Children's Hospital in Makkah. CHILDREN (BASEL, SWITZERLAND) 2024; 11:100. [PMID: 38255413 PMCID: PMC10814964 DOI: 10.3390/children11010100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/06/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
In this study, we assess healthcare providers' adherence to therapeutic drug monitoring (TDM) guidelines for gentamicin in neonates. Conducted at the Maternity and Children's Hospital in Makkah, Saudi Arabia, from July 2020 to July 2022, it retrospectively analyzed the compliance of healthcare workers in managing neonates treated with gentamicin. Covering 410 neonates, primarily diagnosed with respiratory distress (56%) and sepsis (32%), the study revealed that while a majority of trough and peak levels conformed to guidelines, substantial deviations were noted in cases of respiratory distress. This underlines the necessity for targeted TDM strategies, particularly in managing respiratory distress in neonates, to ensure optimal treatment efficacy and safety. The findings urge stringent compliance with TDM guidelines, emphasizing personalized approaches in neonatal gentamicin therapy for improved healthcare outcomes.
Collapse
Affiliation(s)
- Abdullah Najeh Bajaber
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Mahmoud Elrggal
- Pharmacology & Toxicology Department, Faculty of Medicine, Al Qunfudah, Umm Al-Qura University, Makkah 21961, Saudi Arabia
| | - Wajdi F. Organji
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Mohammad Adil Sulaimani
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Raed Mohammed Refai
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Ashraf Alsaedi
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Salwa Hashim Alzamzami
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Fatimah Bakor Hawsawi
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Saud Tanadhub Alnefaie
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Azhar Ali Alsulaimani
- Maternity and Children Hospital, Ministry of Health, Makkah 24246, Saudi Arabia; (A.N.B.); (W.F.O.); (M.A.S.); (R.M.R.); (A.A.); (S.H.A.); (F.B.H.); (S.T.A.); (A.A.A.)
| | - Adnan Alharbi
- Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.A.); (M.A.); (A.S.A.)
| | - Mohammed Alnuhait
- Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.A.); (M.A.); (A.S.A.)
| | - Abdullah S. Alshammari
- Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.A.); (M.A.); (A.S.A.)
| | - Abdu Aldarhami
- Department of Medical Microbiology, Faculty of Medicine, Al Qunfudah, Umm Al-Qura University, Makkah 21961, Saudi Arabia;
| | - Sharaf E. Sharaf
- Pharmaceutical Sciences Department, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| |
Collapse
|