Ugeskr Læger 2005;167(21): 2266-2270
Summary Antibiotics and overweight Ugeskr Læger 2005;167: 2266-2270 We have searched the literature in an attempt to determine whether overweight persons need a different dose of antibiotics than do normal-weight persons. It seems clear that aminoglycosides require individual dosing to avoid subtherapeutic levels in both overweight persons and large standard-weight persons. For quinolones, the standard dosage for ciprofloxacin (400 mg× 2 intravenously or 500 mg× 2 orally) will be sufficient for patients weighing up to 140 kg. Vancomycin dosage (1 g× 2) might need to be increased for patients weighing more than 100 kg. Regarding β -lactam antibiotics, the documentation is sparse and contradictory, and further studies are needed. In very overweight persons (BMI > 30) with infections leading to hospital admissions, increasing the dosage and dosing frequency (penicillin 2 MIE× 4, dicloxacillin 1.5 g× 4, ampicillin 2 g×4) might be considered. Regarding cephalosporins, increasing the dosage of cephalosporins (cefuroxime 1.5 g× 3) should be considered, even though the documentation for this is sparse.