- Gaz du Sang, Hôpital NordLaboratoire de Pharmacologie - Toxicologie , CHU de Saint-Etienne, France.
Service de Médecine Intensive et Réanimation G, CHU de Saint-Etienne, Saint Etienne, France.
Expert Opin Drug Metab Toxicol. 2022 Apr;18(4):277-284. doi: 10.1080/17425255.2022.2080052. Epub 2022 May 30.
Ceftazidime is used for the treatment of many bacterial infections, including severe infections. Like other beta-lactams, inter-individual variability in ceftazidime pharmacokinetics has been described. Due to its related pathophysiological modifications, obesity might influence ceftazidime pharmacokinetics.
The objective of this review is to assess the current state of knowledge about the impact of obesity on ceftazidime treatment. A literature search was conducted on PubMed-MEDLINE (2016-2021) to retrieve pharmacokinetic studies published in English, matching the terms 'ceftazidime' AND 'pharmacokinetics.'
The impact of obesity on pharmacokinetics is generally poorly known, mainly because obese patients are often excluded from clinical studies. However, the published literature clearly shows that obese patients have significantly lower ceftazidime concentrations. This could be explained by increased volume of distribution and clearance. This low exposure represents a major factor of therapeutic failure, potentially fatal for critically ill patients. While further studies would be useful to better assess the magnitude and understanding of this variability, the use of higher doses of ceftazidime is needed in obese patients. Moreover, therapeutic drug monitoring for dose adaptation is of major interest for these patients, as the efficacy of ceftazidime seems to be directly related to its plasma concentration.
头孢他啶用于治疗多种细菌感染，包括严重感染。与其他β-内酰胺类药物一样，头孢他啶的药代动力学在个体间存在差异。由于相关的病理生理改变，肥胖可能会影响头孢他啶的药代动力学。
本综述的目的是评估目前关于肥胖对头孢他啶治疗影响的知识状况。在 PubMed-MEDLINE（2016-2021 年）上进行了文献检索，以检索以“ceftazidime”和“pharmacokinetics”为关键词发表的英文药代动力学研究。
肥胖对药代动力学的影响通常知之甚少，主要是因为肥胖患者通常被排除在临床试验之外。然而，已发表的文献清楚地表明，肥胖患者的头孢他啶浓度明显较低。这可能是由于分布容积和清除率增加所致。这种低暴露是治疗失败的一个主要因素，对重症患者可能是致命的。虽然进一步的研究将有助于更好地评估这种变异性的程度和理解，但肥胖患者需要使用更高剂量的头孢他啶。此外，为了适应剂量，进行治疗药物监测对于这些患者非常重要，因为头孢他啶的疗效似乎与其血浆浓度直接相关。
