Abstract
OBJECTIVE: To investigate whether weight adjusted ciprofloxacin dosing results in comparable target site concentrations in obese and lean subjects.
DESIGN: Comparative study in two populations.
SUBJECTS: Twelve obese subjects (mean weight 122±22.6 kg, 28–52 y, male : female ratio 4 : 8) and 12 age- and sex-matched lean controls (mean weight 59±8.6 kg).
METHODS: Sampling of interstitial space fluid by means of calibrated in vivo microdialysis after a weight-adjusted intravenous bolus dose of 2.85 mg/kg ciprofloxacin. Analysis of drug concentration by high pressure liquid chromatography.
RESULTS: We found significantly higher peak and trough levels of ciprofloxacin in plasma for obese subjects (9.97±5.64 and 0.44±0.10 µg/ml vs 2.59±1.06 and 0.19±0.09 µg/ml in lean subjects, P<0.05), while concentration–time curves of interstitial fluid of muscle and subcutaneous fat did not differ between the groups. Tissue penetration, expressed as AUCtissue/AUCplasma ratio was significantly lower in obese subjects (0.45±0.27 vs 0.82±0.36, P<0.01).
CONCLUSION: We conclude that the penetration process into the interstitial space fluid is impaired in obese subjects. Therefore antibiotic doses need not be adjusted for an increase in fat/water ratio. Weight-adjusted dosing based on actual body weight will yield adequate tissue levels for ciprofloxacin.
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References
Wurtz R, Itokazu G, Rodvold K . Antimicrobial dosing in obese patients Clin Infect Dis 1997 25: 112–118.
Devine BJ . Gentamicin therapy Drug Intell Clin Pharm 1974 8: 650–655.
Dudley MN . Antibiotic dosing in obese children Pediatr Infect Dis J 1993 12: 420.
Ungerstedt U . Microdialysis—principles and applications for studies in animal and man J Intern Med 1991 230: 365–373.
Müller M, Haag O, Burgdorff T, Georgopoulos A, Weninger W, Jansen B, Stanek G, Pehamberger H, Agneter E, Eichler HG . Characterization of peripheral–compartment kinetics of antibiotics by in vivo microdialysis in humans Antimicrob Agents Chemother 1996 12: 2703–2709.
Krol GJ, Beck GW, Benham T . HPLC analysis of ciprofloxacin and ciprofloxacin metabolites in body fluids J Pharm Biomed Anal 1995 14: 181–190.
Wilson MG, Kelley K, Thornhill TS . Infection as a complication of total knee-replacement arthroplasty. Risk factors and treatment in sixty-seven cases J Bone Joint Surg Am 1990 72: 878–883.
Medina M, Sillero M, Martinez-Gallego G, Delgado-Rodriguez M . Risk factors of surgical wound infection in patients undergoing herniorrhaphy Eur J Surg 1999 163: 191–198.
Jansson PA, Larsson A, Lönnroth PN . Relationship between blood pressure, metabolic variables and blood flow in obese subjects with or without non-insulin-dependent diabetes mellitus Eur J Clin Invest 1998 28: 813–818.
Summers LK, Samra JS, Humphreys SM, Morris RJ, Frayn KN . Subcutaneous abdominal adipose tissue blood flow: variation within and between subjects and relationship to obesity Clin Sci Colch 1996 91: 679–683.
Laakso M, Edelman SV, Brechtel G, Baron AD . Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. A novel mechanism for insulin resistance J Clin Invest 1990 85: 1844–1852.
Traynor AM, Nafziger AN, Bertino JS Jr . Aminoglycoside dosing weight correction factors for patients of various body sizes Antimicrob Agents Chemother 1995 39: 545–548.
Bauer LA, Black DJ, Lill JS . Vancomycin dosing in morbidly obese patients Eur J Clin Pharmac 1998 54: 621–625.
Blouin RA, Bauer LA, Miller DD, Record KE, Griffen WO Jr . Vancomycin pharmacokinetics in normal and morbidly obese subjects Antimicrob Agents Chemother 1982 21: 575–580.
Ducharme MP, Slaughter RL, Edwards DJ . Vancomycin pharmacokinetics in a patient population: effect of age, gender, and body weight Ther Drug Monit 1994 16: 513–518.
Penzak SR, Gubbins PO, Rodvold KA, Hickerson SL . Therapeutic drug monitoring of vancomycin in a morbidly obese patient Ther Drug Monit 1998 20: 261–265.
Allard S, Kinzig M, Boivin G, Sorgel F, LeBel M . Intravenous ciprofloxacin disposition in obesity Clin Pharmac Ther 1993 54: 368–373.
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Hollenstein, U., Brunner, M., Schmid, R. et al. Soft tissue concentrations of ciprofloxacin in obese and lean subjects following weight-adjusted dosing. Int J Obes 25, 354–358 (2001). https://doi.org/10.1038/sj.ijo.0801555
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DOI: https://doi.org/10.1038/sj.ijo.0801555
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