title: Dosing Practices of Intravenous Acyclovir for Herpes Encephalitis in Obesity: Results of a Pharmacist Survey.
abstract: BACKGROUND
  Dosing of intravenous acyclovir for herpes encephalitis in obese patients is recommended to be based on ideal body weight. However, limited data support this recommendation, and recent data suggest this may lead to underdosing.
  
  
  OBJECTIVE
  To determine national dosing practices of intravenous acyclovir across a range of patient weights.
  
  
  METHODS
  A survey was distributed to members of the American College of Clinical Pharmacy Critical Care and Infectious Diseases Practice & Research Networks listservs. Data collected included demographic information and dosing of acyclovir, given consistent patient cases with varying patient weight.
  
  
  RESULTS
  A total of 264 pharmacists participated in the survey, with 240 (90.9%) participants completing the survey. Participants were predominately clinical pharmacists. As patient weight increased, respondents were more apt to dose based on an adjusted body weight, with dosing in the obese and morbidly obese showing a clear lack of consistency.
  
  
  CONCLUSIONS
  Intravenous dosing of acyclovir for herpes encephalitis is variable, especially in obese patients, and does not reflect recommendations. Limited data provide conflicting recommendations for dosing in obese patients, and future studies are necessary to optimize patient outcomes and prevent toxicity.
authors.affiliation: 1 Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.affiliation: 2 Department of Pharmacy, UPMC St Margaret, Pittsburgh, PA, USA.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Pickering
authors.affiliation: 3 Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.|4 Antibiotic Management Program, UPMC Presbyterian, Pittsburgh, PA, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Potoski
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage* / Q000493:pharmacokinetics; D061605:Administration, Intravenous; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D020803:Encephalitis, Herpes Simplex / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D010595:Pharmacists; D011795:Surveys and Questionnaires
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir
keywords: acyclovir; herpes encephalitis; infectious disease; obesity; survey