Antibiotics: The dose should correspond to the weight of patients

Doses of antibiotics, which are currently the same for all adults, should be adjusted according to the weight of patients to maximize their effectiveness and prevent their resistance, say specialists.

The practice of adjusting the dosage of drugs according to the size of individuals are already in oncology, anesthesia, intensive care and pediatrics, but this is not the case with antibiotics.

In practice, a man suffering from pneumonia, weighing 90 kg and measuring 1,90m, has a body mass twice a woman of 56 kg and 1,50m.

However, they are "under the current recommendations" given the same dose of antibiotics. This, according to the experts, due to the fact that except for some special populations (children, elderly, hepatic or renal disease) who receive an adjustment of treatment, the regulatory evaluation of antibiotics demands proof of efficacy in a general population.

However, "there is evidence that the pharmacokinetics of certain drugs (how they behave in the body) varies depending on the size and body composition. The metabolism of drug processing can also be changed.

The Greek researchers note that achieving the proper therapeutic dose is important not only for treatment efficacy in patients, but also to prevent the onsets of the resistance to the drug. The latter may occur when treatment is insufficiently effective.

Adjusting the dose is also necessary to reduce toxicity. This approach has led to a revival of polymyxins and daptomycin, which are useful antibiotics bu which had virtually been abandoned because of concerns about toxicity.

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