By Syed Tabish R. Zaidi, Jason A. Roberts
This publication offers an up to the moment overview on antimicrobials dosing in overweight sufferers, together with perform strategies for scientific use. The ebook is written via a bunch of medical professionals and pharmacists operating in infectious ailments perform and research.
The introductory bankruptcy outlines the $64000 physiological adjustments in weight problems together with components affecting the dosing of antimicrobials in overweight sufferers. The introductory bankruptcy is by means of ten chapters masking the key periods of antibiotics, antifungals, and antivirals. each one bankruptcy in short discusses the pharmacokinetics alterations on the topic of weight problems and a precis of the appropriate updated literature. particular dosing strategies are supplied for every type supplemented by way of real-life examples as medical instances which are integrated as an appendix to the booklet. The e-book is an invaluable source for clinicians, scholars and researchers wanting updated info on antimicrobial dosing in overweight sufferers. medical professionals, pharmacists, nurses operating in sanatorium settings, and scholars of healthiness classes (medical, pharmacy and nursing scholars) will locate this ebook rather useful.
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Additional resources for Drug Dosing in Obesity: Volume I: Antimicrobials
Example text
Such factors include simple diffusion rates, plasma protein binding, active transport, and tissue-site metabolism [14]. Tissue distribution is particularly important in surgical prophylaxis, where high tissue concentrations for the duration of surgery are required. Under normal conditions and weight, blood flow in fat is poor and accounts for approximately 5 % of cardiac output, whereas in the lean tissues this is 22 %. In morbid obesity, the percentage of fat per kilogram of total body weight is increased relative to lean tissue mass.
Cefazolin dosing for surgical prophylaxis in morbidly obese patients. Surg Infect. 2012;13(1):33–7. 19. Pevzner L, Swank M, Krepel C, et al. Effects of maternal obesity on tissue concentrations of prophylactic cefazolin during Caesarian delivery. Obstet Gynecol. 2011;117(4):877–82. 38 C. R. Zaidi 20. Barbour A, Schmidt S, Rout WR, et al. Soft tissue penetration of cefuroxime determined by clinical microdialysis in morbidly obese patients undergoing abdominal surgery. Int J Antimicrob Agents. 2009;34(3):231–5.
While other factors are responsible for the additional risk of surgical site infection, dose optimization has decreased surgical site infection rates [17]. A number of studies on surgical prophylaxis have been conducted for cephazolin. The pivotal 1989 study by Forse et al. showed that a 2 g dose in obese patients produced similar plasma and tissue levels as a 1 g dose in normal patients [16]. 6 %. Another study in 38 morbidly obese patients who were given 2 g of cephazolin at incision and another 2 g at 3 h during operation, showed that even a 2 g dose did not reach therapeutic tissue concentrations, defined as less than 8 µg/g.