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vancomycin obese

N P Fewel
WHAT IS KNOWN AND OBJECTIVE: There are many methods for dosing vancomycin. The purpose of this commentary was to compare open-access vancomycin dosing websites with and describe how body weight can affect their pharmacokinetic (PK) calculations. COMMENT: A vancomycin dosing website,, was developed to improve the dosing practice at our health system. Nine other vancomycin dosing calculators were identified, including three open-access websites...
October 18, 2016: Journal of Clinical Pharmacy and Therapeutics
Ambar Haleem, Hsiu-Yin Chiang, Ravindhar Vodela, Andrew Behan, Jean M Pottinger, Joseph Smucker, Jeremy D Greenlee, Charles Clark, Loreen A Herwaldt
OBJECTIVE To identify risk factors for surgical site infections (SSIs) after spine operations. DESIGN Case-control study of SSIs among patients undergoing spine operations. SETTING An academic health center. PATIENTS We studied patients undergoing spinal fusions or laminectomies at the University of Iowa Hospitals and Clinics from January 1, 2007, through June 30, 2009. We included patients who acquired SSIs meeting the National Healthcare Safety Network definition. We randomly selected controls among patients who had spine operations during the study period and did not meet the SSI definition...
August 30, 2016: Infection Control and Hospital Epidemiology
Sara Elizabeth Boyd, Esmita Charani, Tracy Lyons, Gary Frost, Alison Helen Holmes
BACKGROUND: Obesity is on course to overtake being underweight as a global disease burden. Obesity alters antibacterial pharmacokinetics (PK) and pharmacodynamics (PD). Historically, drug PK/PD parameters have not been studied in obese populations. This means dose recommendations risk being sub-therapeutic in a population at increased risk of infection. Suboptimal antibacterial prescribing is widely associated with treatment failure, worse clinical outcomes, unnecessary escalation to broad-spectrum therapy and the emergence of antimicrobial resistance (AMR)...
August 18, 2016: Journal of Antimicrobial Chemotherapy
Céline Rens, Françoise Laval, Mamadou Daffé, Olivier Denis, Rosangela Frita, Alain Baulard, Ruddy Wattiez, Philippe Lefèvre, Véronique Fontaine
Tuberculosis is still a cause of major concern, partly due to the emergence of multidrug-resistant strains. New drugs are therefore needed. Vancomycin can target mycobacteria with cell envelope deficiency. In this study, we used a vancomycin susceptibility assay to detect drugs hampering lipid synthesis in Mycobacterium bovis BCG and in Mycobacterium tuberculosis We tested three drugs already used to treat human obesity: tetrahydrolipstatin (THL), simvastatin, and fenofibrate. Only vancomycin and THL were able to synergize on M...
October 2016: Antimicrobial Agents and Chemotherapy
Dorien Reijnders, Gijs H Goossens, Gerben D A Hermes, Evelien P J G Neis, Christina M van der Beek, Jasper Most, Jens J Holst, Kaatje Lenaerts, Ruud S Kootte, Max Nieuwdorp, Albert K Groen, Steven W M Olde Damink, Mark V Boekschoten, Hauke Smidt, Erwin G Zoetendal, Cornelis H C Dejong, Ellen E Blaak
The gut microbiota has been implicated in obesity and cardiometabolic diseases, although evidence in humans is scarce. We investigated how gut microbiota manipulation by antibiotics (7-day administration of amoxicillin, vancomycin, or placebo) affects host metabolism in 57 obese, prediabetic men. Vancomycin, but not amoxicillin, decreased bacterial diversity and reduced Firmicutes involved in short-chain fatty acid and bile acid metabolism, concomitant with altered plasma and/or fecal metabolite concentrations...
July 12, 2016: Cell Metabolism
Hsin Lin, Daniel Dante Yeh, Alexander R Levine
BACKGROUND: Limited data are available assessing vancomycin concentrations in obese critically ill patients. Currently, there are no studies evaluating dosing requirements in this population who receive vancomycin administered as a continuous infusion (CI). The aim of this study was to assess whether there was a difference in the weight-based maintenance dose required to reach a therapeutic vancomycin concentration at 24 hours when given as a CI in obese versus non-obese critically ill patients...
2016: Critical Care: the Official Journal of the Critical Care Forum
Ian G Woodgate, John Rooney, Johnathan S Mulford, R Mark Gillies
INTRODUCTION: This is a report of a mechanical failure of an S-ROM revision total knee prosthesis. The prosthesis was used as a revision implant following deep peri-prosthetic infection in a morbidly obese male. The prosthesis failed on both the femoral and tibial sides at the modular metaphyseal stem junctions and required a further revision using the same type of implant after infection was excluded. CASE PRESENTATION: A 57 year old male had previously undergone a left total knee arthroplasty in 1999 for osteoarthritis...
January 2016: Journal of Orthopaedic Case Reports
Abdulaziz S Alobaid, Maya Hites, Jeffrey Lipman, Fabio Silvio Taccone, Jason A Roberts
The increased prevalence of obesity presents challenges for clinicians aiming to provide optimised antimicrobial dosing in the intensive care unit. Obesity is likely to exacerbate the alterations to antimicrobial pharmacokinetics when the chronic diseases associated with obesity exist with the acute pathophysiological changes associated with critical illness. The purpose of this paper is to review the potential pharmacokinetic (PK) changes of antimicrobials in obese critically ill patients and the implications for appropriate dosing...
April 2016: International Journal of Antimicrobial Agents
Desiree E Kosmisky, Carrie L Griffiths, Megan A Templin, James Norton, Kelly E Martin
BACKGROUND: Optimal dosing of vancomycin in morbidly obese patients (>100 kg and at least 140% of their ideal body weight) has not been determined. Conventional dosing strategies have led to the observation of supratherapeutic trough concentrations (>20 mcg/mL). OBJECTIVE: To evaluate the effectiveness of a new vancomycin dosing protocol in morbidly obese patients in achieving therapeutic trough concentrations between 10 and 20 mcg/mL and to determine patient-specific factors influencing the trough concentration attained...
October 2015: Hospital Pharmacy
Rocío Álvarez, Luis E López Cortés, José Molina, José M Cisneros, Jerónimo Pachón
The increasing number of infections produced by beta-lactam-resistant Gram-positive bacteria and the morbidity secondary to these infections make it necessary to optimize the use of vancomycin. In 2009, the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Disease Pharmacists published specific guidelines about vancomycin dosage and monitoring. However, these guidelines have not been updated in the past 6 years. This review analyzes the new available information about vancomycin published in recent years regarding pharmacokinetics and pharmacodynamics, serum concentration monitoring, and optimal vancomycin dosing in special situations (obese people, burn patients, renal replacement therapy, among others)...
May 2016: Antimicrobial Agents and Chemotherapy
Nuggehally R Srinivas
Owing to availability of scanty pharmacokinetic data, dosing decisions in morbidly obesity is increasingly challenging in the field of anti-infective drugs. However, in recent years data are emerging that describe the pharmacokinetics of anti-infective drugs in morbidly obese subjects. The objectives of the present work were: (1) to collate the recent reports pertaining to the pharmacokinetics in morbidly obese subjects for several anti-infective drugs and provide an overview of the pharmacokinetic data along with the applicable pharmacodynamics and/or clinical outcome; (2) to perform regression analysis on limited dataset for a few drugs to verify the existence of relationships between Cmax/Ctrough versus steady-state volume of distribution (Vss)/clearance to enable data prediction in morbidly obesity subjects; (3) to provide a general discussion on issues and dosing implications...
January 13, 2016: American Journal of Therapeutics
Sun-Young Park, Sang-Dong Lim
Lactobacillus plantarum FH185 was isolated from the feces of healthy adults. In our previous study, L. plantarum FH185 was demonstrated that it has anti-obesity effect in the in vitro and in vivo test. In order to determine its potential for use as a probiotic, we investigated the physiological characteristics of L. plantarum FH185. The optimum growth temperature of L. plantarum FH185 was 40℃. L. plantarum FH185 showed higher sensitivity to novobiocin in a comparison of fifteen different antibiotics and showed higher resistance to polymyxin B and vancomycin...
2015: Korean Journal for Food Science of Animal Resources
Sun-Young Park, Seong-A Cho, Sae-Hun Kim, Sang-Dong Lim
Obesity is strongly associated with several metabolic and chronic diseases and has become a major public health problem of worldwide concern. This study aimed to investigate the physiological characteristics and anti-obesity effects of Lactobacillus plantarum Q180. Lactobacillus plantarum Q180 was isolated from the faces of healthy adults and found to have a lipase inhibitory activity of 83.61±2.32% and inhibited adipocyte differentiation of 3T3-L1 cells (14.63±1.37%) at a concentration of 100 μg/mL. The strain was investigated for its physiological characteristics...
2014: Korean Journal for Food Science of Animal Resources
Sascha Tafelski, Hailong Yi, Fakher Ismaeel, Alexander Krannich, Claudia Spies, Irit Nachtigall
Worldwide incidence of obesity is increasing and impaired outcome in postoperative patients has been described. Antibiotic prescribing is complicated by different pharmacology in this population. This study evaluates mortality and morbidity of obese postoperative patients and explores possible relation to antibiotic therapy. Therefore, data obtained in a prospective study in 2009-2010 were analysed. Postoperative patients on 5 ICUs were included with >48h of ICU treatment and documented body-mass-index (BMI)...
September 2016: Journal of Infection and Public Health
L A Whiteside
An extensive review of the spinal and arthroplasty literature was undertaken to evaluate the effectiveness of local antibiotic irrigation during surgery. The efficacy of antibiotic irrigation for the prevention of acute post-operative infection after total joint arthroplasty was evaluated retrospectively in 2293 arthroplasties (1990 patients) between January 2004 and December 2013. The mean follow-up was 73 months (20 to 139). One surgeon performed all the procedures with minimal post-operative infection. The intra-operative protocol included an irrigation solution of normal saline with vancomycin 1000 mg/l and polymyxin 250,000 units/l at the rate of 2 l per hour...
January 2016: Bone & Joint Journal
Nurhayat Yakut, Eda Kepenekli Kadayifci, Ayse Karaaslan, Serkan Atici, Gulsen Akkoc, Sevliya Ocal Demir, Adnan Dagcinar, Fatih Akbulut, Ahmet Soysal, Mustafa Bakır
BACKGROUND: Brain abscess is a rare but serious, life-threatening infection in children. It may arise from parameningeal infections such as otitis media, sinusitis and mastoiditis. CASE DESCRIPTION: A ten-year-old boy with the diagnosis of glycogen-storage disease and obesity was admitted to the emergency room with complaints of vomiting, decreased level of consciousness, imbalance on walking. On neurological examination, the patient was ataxic. His cranial magnetic resonance imaging (MRI) examination showed mastoiditis on the right side and 39 × 34 mm abscess formation with surrounding edema on the right cerebellar hemisphere...
2015: SpringerPlus
David W Kubiak, Mohammed Alquwaizani, David Sansonetti, Megan E Barra, Michael S Calderwood
We retrospectively identified 67 patients with severe or morbid obesity (body mass index ≥35 kg/m(2)) who had received intravenous vancomycin at our institution. We observed that an initial dose of 45 to 65 mg/kg vancomycin per day based upon ideal body weight rather than actual body weight was more predictive of initial trough concentrations between 15 and 20 mcg/mL.
December 2015: Open Forum Infectious Diseases
Pedro Hinarejos, Pau Guirro, Lluis Puig-Verdie, Raul Torres-Claramunt, Joan Leal-Blanquet, Juan Sanchez-Soler, Joan Carles Monllau
Bone cement has the capacity to release antibiotic molecules if any antibiotic is included in it, and these elution properties are improved as cement porosity is increased. In vitro studies have shown high local antibiotic concentration for many hours or few days after its use. Antibiotic loaded bone cement (ALBC) is helpful when treating an infection in total knee arthroplasty (TKA) revision surgery. The purpose of this paper was to review the evidence for the routine use of ALBC in TKA in the literature, its pros and cons...
December 18, 2015: World Journal of Orthopedics
Deepak K Rajpal, Jean-Louis Klein, David Mayhew, Joyce Boucheron, Aaron T Spivak, Vinod Kumar, Karen Ingraham, Mark Paulik, Lihong Chen, Stephanie Van Horn, Elizabeth Thomas, Ganesh Sathe, George P Livi, David J Holmes, James R Brown
The gastrointestinal tract microbiome has been suggested as a potential therapeutic target for metabolic diseases such as obesity and Type 2 diabetes mellitus (T2DM). However, the relationship between changes in microbial communities and metabolic disease-phenotypes are still poorly understood. In this study, we used antibiotics with markedly different antibacterial spectra to modulate the gut microbiome in a diet-induced obesity mouse model and then measured relevant biochemical, hormonal and phenotypic biomarkers of obesity and T2DM...
2015: PloS One
Jeff Kingsley, Purvi Mehra, Laura E Lawrence, Eugenia Henry, Erin Duffy, Sue K Cammarata, John Pullman
OBJECTIVES: Delafloxacin is an investigational anionic fluoroquinolone being developed to treat infections caused by Gram-positive and -negative organisms. This clinical trial evaluated the efficacy and safety of delafloxacin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs). METHODS: In a double-blind, Phase 2 trial, 256 patients were randomized (1 : 1 : 1) to 300 mg of delafloxacin, 600 mg of linezolid or 15 mg/kg vancomycin (actual body weight), each administered intravenously twice daily for 5-14 days...
March 2016: Journal of Antimicrobial Chemotherapy
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