Pharmacodynamics and Obesity

Abstract

Five hundred million adults meet the current definition of obesity worldwide. This high global prevalence of obesity offers unique challenges to the selection of the optimal antimicrobial dose. Early phase clinical trials tend to exclude obese healthy volunteers, while late phase clinical trials are not adequately powered to identify potential differences in the clinical outcomes in this population. The interaction of obesity on antimicrobial directed pathogen–host response is also not well described. Hence, dose selection in this population relies on the desire to achieve pharmacokinetic bioequivalence across the clinical body weight distribution. Pharmacodynamic data supporting well-defined doses that optimize outcomes in the obese population are limited. Specific recommendations for antimicrobial dosing should be established through consensus guidance with endorsement from international societies that advocate for the appropriate use of antimicrobials.