title: Pharmacokinetic changes and dosing modification of aminoglycosides in critically ill obese patients: a literature review.
abstract: The objective of the paper is to review the literature and provide recommendations for use of aminoglycoside antibiotics in critically ill obese patients. Literature search in PubMed for all articles on the use of aminoglycosides in critically ill obese patients was conducted, and all articles related to pharmacokinetics in obesity were reviewed. Bibliographies of all searched manuscripts were also reviewed in an attempt to find additional references. Although aminoglycoside pharmacokinetics have been described in detail, data on aminoglycoside use and appropriate dose modification in critically ill obese patients are very limited. Knowledge on aminoglycoside pharmacokinetics and use in critically ill obese patients is incomplete. Pathophysiologic changes in obesity can result in sub- or supra-therapeutic aminoglycoside plasma concentrations, especially in the presence of sepsis. Rigorous clinical studies are needed to establish aminoglycoside dosing guidelines in critically ill obese patients with sepsis.
authors.affiliation: Internal Medicine Department, University Hospital of Patras, Rion 26500, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Velissaris
authors.affiliation: Internal Medicine Department, University Hospital of Patras, Rion 26500, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Karamouzos
authors.affiliation: Internal Medicine Department, University Hospital of Patras, Rion 26500, Greece.
authors.forename: Markos
authors.initials: M
authors.lastname: Marangos
authors.affiliation: Intensive Care Department, Brugmann University Hospital, Brussels 1030, Belgium.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Pierrakos
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Menelaos
authors.initials: M
authors.lastname: Karanikolas
keywords: Amikacin; Aminoglycoside; Critical illness; Gentamicin; Obesity; Pharmacokinetics; Sepsis; Tobramycin