Vancomycin Dose Optimization in Obesity

May 18, 2026 updated by: Manjunath Prakash Pai, University of Michigan

An Open-Label, Single-Dose, Pharmacokinetic Study of Vancomycin Dosed by Weight or Kidney Function in Adults With Obesity

The goal of this clinical trial is to learn how to optimize vancomycin dosing in obese adults based on weight and kidney function. It will also assess the safety of different vancomycin dosing strategies. The main questions it aims to answer are:

Does dosing vancomycin based on kidney function provide better drug exposure than dosing based on weight? What medical or safety issues arise when vancomycin is dosed according to weight versus kidney function? Participants will be randomized into two groups. One group will receive vancomycin doses based on their weight, while the other will receive doses based on their kidney function.

Participants will:

Receive a single dose of vancomycin based on either their weight or kidney function after pretreatment with antihistamines Provide blood and urine samples at specific times for pharmacokinetic analysis Undergo body composition measurements using DEXA scans and other methods Visit the clinic for physical exams, medical history, and laboratory tests

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This prospective, dosing group-randomized, single-dose pharmacokinetic study aims to evaluate vancomycin dosing in healthy obese participants across three BMI and two kidney function categories. Twenty-four participants will be enrolled, stratified by BMI (30-34.9 kg/m², 35-39.9 kg/m², ≥40 kg/m²) and creatinine clearance using dosing weight (CLcr_dw 60-119 mL/min or ≥120 mL/min). Twenty-four participants will be randomized (1:1) into a standard of care vancomycin group (Control) or a kidney function based group (Test). The study will include physical exams, medical history, and laboratory evaluations. Vancomycin doses will be administered based on weight or kidney function after pretreatment with antihistamines. Pharmacokinetic data will be collected through blood and urine samples at specific time points. Body composition measurements will be performed using DEXA and through anthropometric methods. Serum cystatin C concentrations will also be measured. Data analysis will include fitting vancomycin concentration-time data using a 2-compartment linear model to estimate area under the curve (AUC). Group comparisons for AUC target attainment (400-600 h*mg/L) will be performed using Fisher's Exact Test. Additionally, the study will test if the investigators can reduce the standard two-sample method for AUC estimation to a single sample. Different models of estimated glomerular filtration rate (eGFR) will be compared as predictors of vancomycin clearance (CL). This study will provide insights into optimizing vancomycin dosing in obese individuals with varying kidney function, potentially improving therapeutic drug monitoring strategies.

Study Type

Interventional

Enrollment (Actual)

35

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Michigan
      • Ann Arbor, Michigan, United States, 48108
        • Michigan Clinical Research Unit

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. 24 healthy obese participants within three obese class groups; BMI 30-34.9 kg/m2 (n=8), BMI 35-39.9 kg/m2 (n=8), and BMI ≥ 40 kg/m2 (n=8)
  2. Male or female adults age 18 to 50 years
  3. Weight ≥ 80 kg
  4. Estimated creatinine clearance of 60 mL/min to 119 mL/min (n=12) or ≥ 120 mL/min (n=12) (based on the Cockcroft-Gault equation and dosing weight)

Exclusion Criteria:

  1. Pregnant or lactating females
  2. Significant clinical illness within 3 weeks prior to screening
  3. History of severe allergic diseases including drug allergies, with the exception of seasonal allergies
  4. Patients initiated on GLP1 agonists
  5. Any other factor, condition, or disease, including but not limited to cardiovascular, renal, hepatic, or gastrointestinal disorders that may, in the opinion of the Investigator, jeopardize the safety of the participant or impact the validity of the study results.
  6. History of drug addiction or alcohol abuse within the past 12 months
  7. Any clinically significant abnormal lab values (Chemistry and Complete Blood Count) during screening
  8. Participants unwilling or unable to receive vancomycin by intravenous infusion
  9. Individuals with a history of psychiatric or neurological illness, including seizure disorders
  10. Systolic blood pressure less than 90 mm of Hg or more than 140 mm of Hg
  11. Diastolic blood pressure less than 60 mm of Hg or more than 90 mm of Hg
  12. Pulse rate <50 beats/minute or >100 beats/minute.
  13. History of hypersensitivity or infusion reaction to vancomycin, cetirizine, or famotidine
  14. Participants with underlying hearing loss
  15. Participants that are taking ototoxic drugs

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control
Weight-stratified dosing as the current standard of care
Drug: Vancomycin (IV)
Vancomycin weight-based or kidney function-based dosing
Experimental: Test
Kidney function stratified dosing
Drug: Vancomycin (IV)
Vancomycin weight-based or kidney function-based dosing

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Probability of target attainment
Time Frame: 24 hours
Number of participants with a vancomycin area under the concentration-time curve that is between 400 h*mg/L and 600 h*mg/L after a single dose.
24 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Michigan

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2025

Primary Completion (Actual)

April 27, 2026

Study Completion (Actual)

April 27, 2026

Study Registration Dates

First Submitted

September 11, 2024

First Submitted That Met QC Criteria

September 13, 2024

First Posted (Actual)

September 19, 2024

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 18, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HUM00256444
  • 75F40122C00147 (Other Grant/Funding Number: Health and Human Services, Department of-Food and Drug Administration)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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