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Current Fungal Infection Reports

Erschienen in:

06.02.2019 | Pharmacology and Pharmacodynamics of Antifungal Agents (N Beyda, Section Editor)

Dosing Antifungals in Obesity: a Literature Review

verfasst von: Jarrett R. Amsden, Douglas Slain

Erschienen in: Current Fungal Infection Reports | Ausgabe 1/2019

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Abstract

Purpose of Review

To summarize the available evidence regarding antifungal dosing in obese adults as well as to provide meaningful guidance on the dosing of each antifungal agent in obese patients.

Recent Findings

The pharmacokinetic evidence regarding dosing antifungal agents in obesity is limited. Fluconazole’s volume of distribution (VD) is influenced by BMI. Therapeutic drug monitoring (TDM) studies provide some insights into dosing voriconazole in obesity, but not with posaconazole. Isavuconazole seems to be unaffected by weight. The available data for echinocandins suggests that increased doses are likely necessary in obese patients. TDM may be beneficial, particularly for azoles when available in a timely manner.

Summary

Fluconazole and voriconazole dosing should be based on total body weight and adjusted body weight, respectively. Posaconazole may have reduced exposures in obese patients, but data on its new dosage forms is lacking. Isavuconazole appears unaffected by weight. Echinocandin doses likely need to be increased in obese patients, but the exact weight and dosages remain elusive.

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Titel: Dosing Antifungals in Obesity: a Literature Review
verfasst von: Jarrett R. Amsden
Douglas Slain
Publikationsdatum: 06.02.2019
Verlag: Springer US
Erschienen in: Current Fungal Infection Reports / Ausgabe 1/2019
Print ISSN: 1936-3761
Elektronische ISSN: 1936-377X
DOI: https://doi.org/10.1007/s12281-019-0335-3

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