Abbrev. | Definition How to estimate ‘Application ‘ABW. | Actual body weight | Weigh patient Loading dose for lipophilic drugs. BW | idea! body weight | Male: 50 + [0.91 x (eightiom) | Maintenance dose of drugs where clearance is unchanged +1524) inobesity ‘AGjBW | Adjusted body weight | Female: 45.5 + [0:91 x heightlon) | Maintenance dose of drugs with increased clsrance in (Estimate of fat free | - 182.4) obesity mass) IW 4 04 x (ABW IB) For example a 16Okg man whose height is 170om (EMI = 65.4), ‘ABW = 160K, IBW = 66kg and AJBW = 103 6kg ‘Weight used for dosing Remarks No Brug ew | ABW | AgeW 1 | i Acyelvie y 2 | Amikacin v BMI> 40ighn uso ABW, followed by TOMbasod dose adustment Consider capping at 22.59 per dose. 3. | VAmpharercin 8 y Both conventional & lpesomal products 4 | vAmpciin y Use upper end of recommended doses cr use more Frquently 5 | 1 Benzypeniciin Use higher end of recommended dose. (R-4MU g16h in severe infections. 6 | IV Ceazoin y sea 2g per dose in ait obese patients‘Weight used fo dosing Remarks No Prog ew | as | adjew 7 | WCettiaxone Use higher end af recommended dose, Leating dose 2 folloned by 29 gI2h 8 | WCorofoxacin V | 45mghaicose [eis 880 suggested tht 600mg a12h's beter than 400m ah Doses of 800mg 2h n moro abesty have been used 9 | Wctndamyen ‘Serious infection: 600mg 1.2 in dvided 24 died doses. In ife tveatening infections = use doses up to 489 daly in divided ses [200mg ah Doses of < 1Omghg/2ah have been shown to worsen outcomes in arbi obese. 10 | W Calstimethate q Refer to appendix A. {Palyinin El 11 | W Daptomyein Y 12 | Ol Ethembute v Max daly dose 16 13 | W Fhconszale v Based on higher end of 12mg. 14 | W Fucytsine q 15 | W Ganciclovir vRemarks No Drug 16 | IV Gentamicin ‘AGjBW used forint dose folawed by TOM based dose adjustment 17 | Octisoniais Max diy dose 300m 18 |W Linezos ations weighing = 160k, use 600mg 2, Sutfsent for teating sin 80 ssu8 nections. 19 | W Metronidazole Use standard dosing. Doses upto 75mg (upto Ta Bh can be used for veatment of ereerobi bacterial nections 20 | IN Meropenem Use standard dosing, however consider dosing af vaper end of recommended dose 89.25 a8 21 |v PipersiiyTazobectam 4 Give a cominuousinfusion especialy fr isolates wih high MIC 22 | Oral Prasad v Max aay. 23 | Ora Ritsmpcin Max diy dose 125, 24 | vita Sapromyein Max diy dose 19 25 | IN Timethopin Use Adj > 20% del BV n thers, use idea BW. SuiterethoxazleWeight used for dosing Remarks No Drug vw | Aaw | Aajaw 26 | Vancomycin v ABW used for ntl dose folowed by TDMAbasod dose adjustment. May need to shorten interval to maintain increased trough level of 1520mai 9. ah. 27 | WVerconszo' | Use taW or Ac Bin morta obese 28 |W Anidultungin Use standard dosing WV Dorpener WV Etapenem Bibliography: 1. CurrOpin infec Dis 201225: 634-649 2. UKCPA.Citeal Care Group; Drug dosing in extremes of body ‘weight in rial il pationts; 2 edion 2016 3. Int J Antimicrob Agents 2016; 47: 253.68 4 Antimicra Agents Chemether 2012; 57: 184-49