Fixed Dosing of Liposomal Amphotericin B in Morbidly Obese Individuals

Roeland E Wasmann, Cornelis Smit, Eric P H van Dongen, René M J Wiezer, Jill Adler-Moore, Yvo M de Beer, David M Burger, Catherijne A J Knibbe, Roger J M Brüggemann, Roeland E Wasmann, Cornelis Smit, Eric P H van Dongen, René M J Wiezer, Jill Adler-Moore, Yvo M de Beer, David M Burger, Catherijne A J Knibbe, Roger J M Brüggemann

Abstract

In this prospective study, we examined the pharmacokinetics of 1 and 2 mg/kg liposomal amphotericin B in 16 morbidly obese individuals (104-177 kg). Body size had no effect on clearance. We recommend a fixed dose in patients ≥100 kg (ie, 300 or 500 mg rather than the current dose of 3 and 5 mg/kg, respectively). Clinical Trials Registration NCT02320604.

Keywords: fungal infection; fungal treatment; obese; optimal dosing; population pharmacokinetics.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Monte-Carlo simulations based on the final model of the steady-state AUC0-24h and Cmax after a daily 3-mg/kg (solid line) L-AmB dose infused in 1 hour. The dashed line represents the situation were the dose is capped on a 100-kg individual (300 mg AmBisome). The shaded areas represent the 90% confidence intervals of the prediction. Abbreviations: AUC0-24h, area under the curve; Cmax, maximum concentration.

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