Dosing of antimicrobials in obesity: Difference between revisions
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! Drug !! Usual Dose !! Obesity !! Max dose |
! Drug !! Usual Dose !! Obesity !! Max dose |
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| [[Ciprofloxacin]] |
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| 500-750 mg PO q12h or 400 mg IV q6-8h |
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| 400 mg IV q8h or 750 mg PO q12h |
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| [[Levofloxacin]] |
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| 750 mg PO q24h |
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| Consider up to 1000 mg PO q24h |
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| [[Moxifloxacin]] |
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| Usual dose |
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Revision as of 16:08, 9 December 2019
Calculating Body Weight
| Statistic | Equation (Male) | Equation (Female) | Notes |
|---|---|---|---|
| Body mass index (BMI) (kg/m2) | weight, kg / (height, m)2 | ||
| Body surface area (BSA) (m2) | (height, cm × weight, kg / 3600)1/2 | ||
| Ideal body weight (IBW) (kg) | 50 + 2.3 × (inches over 5 ft) | 45.5 + 2.3 × (inches over 5 ft) | |
| Adjusted body weight (ABW) (kg) | IBW + C × (TBW - IBW) | C = 0.3 to 0.4 | |
| Lean body weight (LBW) (kg) | 9270 × TBW / 6680 + 216 x BMI | 9270 × TBW / 8780 + 244 x BMI | |
| Fat-free weight (FFW) (kg) | 0.00139 × (height, cm)2 - 0.0801 × R + 0.187 × TBW + 39.83 | 0.00151 × (height, cm)2 - 0.0344 × R + 0.14 × TBW - (0.158 × age) + 20.387 | R = resistance |
Antibiotics
Penicillins
| Drug | Usual Dose | Obesity | Max dose |
|---|---|---|---|
| Amoxicillin | 1 g PO q8h | No data | |
| Ampicillin | 2 g IV q4h | ||
| Nafcillin | 2 g IV q4h | No data | |
| Piperacillin-tazobactam | 4.5 g IV q6-8h | Prolonged infusion | 18 g daily |
Cephalosporins
| Drug | Usual Dose | Obesity | Max dose |
|---|---|---|---|
| Cefazolin | 1-2 g IV q8h | 2-3 g IV q6-8h | No data; 12 g daily |
| Cephalexin | 500-1000 g PO qid | 1000 g PO qid | No data |
| Cefipime | 2 g IV q8h | 2 g IV q8h prolonged infusion | 2 g IV q8h prolonged infusion |
| Ceftazidime | 2 g IV q8h | 2 g IV q8h prolonged infusion | 2 g IV q8h prolonged infusion |
| Ceftazidime-avibactam | Usual dose | ||
| Ceftolozane-tazobactam | Usual dose |
Carbapenems
| Drug | Usual Dose | Obesity | Max dose |
|---|---|---|---|
| Doripenem | Consider extended infusion | ||
| Ertapenem | 1 g IV q24h | Usual dose | |
| Imipenem | |||
| Meropenem | Consider prolonged infusion |
Quinolones
| Drug | Usual Dose | Obesity | Max dose |
|---|---|---|---|
| Ciprofloxacin | 500-750 mg PO q12h or 400 mg IV q6-8h | 400 mg IV q8h or 750 mg PO q12h | |
| Levofloxacin | 750 mg PO q24h | Consider up to 1000 mg PO q24h | |
| Moxifloxacin | Usual dose |
Macrolides
| Drug | Usual Dose | Obesity | Max dose |
|---|
Tetracyclines
| Drug | Usual Dose | Obesity | Max dose |
|---|
Others
| Drug | Usual Dose | Obesity | Max dose |
|---|---|---|---|
| Aztreonam | 2 g IV q6-8h | ||
| Colistin | Use IBW | 360 mg daily (nephrotoxicity) | |
| Polymyxin B | Use ABW0/4 | 200 mg or 2 MU daily (toxicity) |
Further Reading
- Comprehensive Guidance for Antibiotic Dosing in Obese Adults. Pharmacotherapy. 2017;37(11):1415-1431. doi: 10.1002/phar.2023
