Evaluation of a capped dosing telavancin regimen compared to standard dosing at a large community teaching hospital

2021 ◽  
Author(s):  
Fernando J. Diggs ◽  
Jonathan D. Edwards ◽  
Kimberly B. Garza ◽  
Ali A.M. Hassoun ◽  
Spencer H. Durham
Keyword(s):  
Body Weight ◽  
Adverse Effects ◽  
Teaching Hospital ◽  
Total Body Weight ◽  
Obese Patients ◽  
Dosing Regimen ◽  
Large Community ◽  
Total Body ◽  
Community Teaching ◽  
Equal Efficacy

Telavancin, a lipoglycopeptide antibiotic, is traditionally dosed as 10 mg/kg based on total body weight, but is associated with toxicities that limit its use. This study supports the use of a capped dosing regimen of 750 mg in obese patients, which is associated with equal efficacy and fewer adverse effects compared to traditional dosing.

scholarly journals 196. Assessing the Clinical Impact of Intravenous Acyclovir Dosing in Obese Patients: Should We Be Using Ideal, Adjusted, or Total Body Weight?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Nicole Mulvey ◽  
Sumeet Jain ◽  
Keith Falsetta ◽  
Thien-Ly Doan
Keyword(s):  
Body Weight ◽  
Length Of Stay ◽  
Adverse Effects ◽  
Total Body Weight ◽  
Small Sample ◽  
Obese Patients ◽  
Duration Of Therapy ◽  
Significant Difference ◽  
Total Body ◽  
Island Jewish Medical

Abstract Background Obesity impacts the pharmacokinetics and pharmacodynamics of medications. Pharmacokinetic studies of intravenous (IV) acyclovir have demonstrated that dosing obese patients according to their ideal body weight (IBW) may provide a sub-therapeutic dose, while dosing based on total body weight (TBW) may increase adverse effects. This has led to the use of adjusted body weight (AdjBW) for dosing in this population; however, this has not been evaluated clinically. The purpose of this study is to assess the impact of different dosing strategies of IV acyclovir in obese patients. Methods This retrospective observational chart review evaluated adult patients admitted to Long Island Jewish Medical Center with a body mass index greater than or equal to 30 kg/m2 who received at least 48 hours of high-dose IV acyclovir therapy during the study period of January 2014 to August 2019. Patients were stratified to IBW, AdjBW, and TBW for analysis. The primary statistical tests utilized include descriptive statistics and logistic regression. The primary endpoint was the outcome of infection. The secondary endpoints included duration of therapy, length of stay, and adverse effects. Results 51 patients were included in the efficacy analysis and 84 patients were included in the safety analysis. Treatment failure occurred in 3 out of 51 patients (1 patient in IBW group, 2 patients in AdjBW group, p=0.445). There was no significant difference in median length of stay (p=0.977) or median duration of IV therapy (p=0.78). Nephrotoxicity occurred in 22.2%, 19.2%, and 22.7% of patients in the IBW, AdjBW, and TBW groups respectively (p=1). Conclusion When comparing different dosing modalities, there was no significant difference in the outcome of infection, duration of therapy, or length of stay. The results of this study were limited by small sample size. However, dosing patients according to AdjBW led to smaller doses of acyclovir, and therefore less drug exposure. Disclosures All Authors: No reported disclosures

scholarly journals Colistin Dosing and Nephrotoxicity in a Large Community Teaching Hospital

2010 ◽  
Vol 54 (10) ◽  
pp. 4503-4505 ◽  
Author(s):  
C. Andrew DeRyke ◽  
Amanda J. Crawford ◽  
Nizam Uddin ◽  
Mark R. Wallace
Keyword(s):  
Body Weight ◽  
Actual Body ◽  
Teaching Hospital ◽  
Adult Patients ◽  
Obese Patients ◽  
Actual Body Weight ◽  
Large Community ◽  
Community Teaching

ABSTRACT Thirty adult patients who received intravenous colistin (5.1 ± 2.4 mg/kg/day) were reviewed to evaluate dosing with respect to nephrotoxicity, which occurred in 10 (33%) patients within the first 5 days of treatment. Excessive colistin dosing was frequent (47%), often (71%) resulted from the use of actual body weight in obese patients, and was associated with higher rates of nephrotoxicity (80% versus 30%, P = 0.019).

P0264ASSESSMENT OF GFR IN MORBIDLY OBESE PATIENTS USING DIFFERENT EQUATIONS: WHICH IS THE BEST?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alaa Sabry ◽  
Amir Basiony ◽  
Mohamed Kamal
Keyword(s):  
Body Weight ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Total Body Weight ◽  
Lean Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbidly Obese Patient ◽  
Gault Formula ◽  
Total Body

Abstract Background and Aims Obesity is a potent risk factor for the development of kidney disease. The prevalence of abdominal obesity in Egyptians based upon the European cut-off points was 30.2% for men and 70.9% for women. To detect the best formula for estimation of glomerular filtration rates in morbidly obese individuals. Method: In this prospective study 82 morbidly obese patients were included, Age: 15 to 65 years, Morbidly obese patient (BMI > 40 Kg/m2), Creatinine clearance calculated from a 24-h urine was done, Estimated glomerular filtration rate (eGFR): It was assessed to be correlated with creatinine clearance and detect the most suitable formula for morbidly obese patients. Cockcroft-Gault formula:  Cockcroft-Gault formula (for total body weight): ockcroft-Gault formula (for adjusted body weight): Cockcroft-Gault formula (for lean body weight), MDRD-eGFR (Modification of Diet in Renal Disease equation) (Shahbaz & Gupta, 2019), CKD-epidemiology (CKD-EPI): (Levey, et al, 2009) Results Demogrphic criteria of the studdied patients Conclusion: The equations that had the nearest values to creatinine clearance were CG-TBW-GFR and CGAjBW- GFR, both of them had a moderate reliability with more agreement for the CG-TBW-GFR equation . The CG-TBW-GFR formula was the most reliable one to measure GFR, followed by the CG-AjBW-GFR formula, while the CG-IBW, CG-LBW, MDRD-GFR and CKD-EPI-GFR formulae were not reliable at all .

Estimation of Total Body Weight in Obese Patients

2009 ◽  
Vol 28 (3) ◽  
pp. 139-145 ◽  
Author(s):  
Cameron S. Crandall ◽  
Stephanie Gardner ◽  
Darren A. Braude
Keyword(s):  
Body Weight ◽  
Total Body Weight ◽  
Obese Patients ◽  
Total Body

scholarly journals Comparative evaluation of atracurium dosed on ideal body weight vs. total body weight in morbidly obese patients

2010 ◽  
Vol 71 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Simone Van Kralingen ◽  
Ewoudt M. W. Van De Garde ◽  
Catherijne A. J. Knibbe ◽  
Jeroen Diepstraten ◽  
Marinus J. Wiezer ◽  
...  
Keyword(s):  
Body Weight ◽  
Comparative Evaluation ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Ideal Body ◽  
Total Body

The Effective Effect-Site Propofol Concentration for Induction and Intubation with Two Pharmacokinetic Models in Morbidly Obese Patients Using Total Body Weight

2012 ◽  
Vol 115 (4) ◽  
pp. 823-829 ◽  
Author(s):  
Ghislaine C. Echevarría ◽  
María F. Elgueta ◽  
María T. Donoso ◽  
Diego A. Bugedo ◽  
Luis I. Cortínez ◽  
...  
Keyword(s):  
Body Weight ◽  
Total Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Pharmacokinetic Models ◽  
Effect Site ◽  
Total Body

The Effective Effect-Site Propofol Concentration for Induction and Intubation With Two Pharmcokinetic Models in Morbidly Obese Patients Using Total Body Weight

2013 ◽  
Vol 57 (2) ◽  
pp. 89
Author(s):  
Ghislaine C. Echevarría ◽  
María F. Elgueta ◽  
María T. Donoso ◽  
Diego A. Bugedo ◽  
Luis I. Cortínez ◽  
...  
Keyword(s):  
Body Weight ◽  
Total Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Effect Site ◽  
Total Body

Estimation of Creatinine Clearance in Patients with Cushing's Syndrome

DICP ◽  
1989 ◽  
Vol 23 (12) ◽  
pp. 974-977 ◽  
Author(s):  
Jimmi Hatton ◽  
Michael D. Parr ◽  
Robert A. Blouin
Keyword(s):  
Body Weight ◽  
Creatinine Clearance ◽  
Cushing’S Syndrome ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Cushing's Syndrome ◽  
Normal Weight ◽  
Poor Correlation ◽  
Obese Patients ◽  
Total Body

The predictive value of the Cockcroft-Gault equation in patients with Cushing's syndrome was evaluated in 23 patients. Patients were subdivided based on total body weight into two groups, obese and nonobese. Estimated creatinine clearance (EC1cr) values were obtained by the Cockcroft-Gault method using ideal body weight (IBW) and total body weight (TBW). These values were then compared with a 24-hour measured creatinine clearance (MClcr). EClcr values based on TBW consistently overestimated measured values in all patients (p<0.05). In obese patients with Cushing's syndrome IBW predictions were not statistically different. However, linear regresson analysis revealed a poor correlation (r=0.32). Daily creatinine production rates (Ucr) were calculated and contrasted with an appropriate historical control for obese and nonobese subjects. Nonobese patients revealed a marked reduction in total Ucr compared with normal-weight controls (p<0.05). Obese patients also showed a reduction in Ucr when compared with a normal obese control population (p<0.05). Difficulty in predicting creatinine clearance in patients with Cushing's syndrome appears to be related to alterations in Ucr. These data suggest that the pathophysiologic changes that accompany Cushing's syndrome are sufficient to alter Ucr and may limit the usefulness of existing methods to predict creatinine clearance and renal function in these patients.

Sign in / Sign up

Export Citation Format

Share Document