Evaluation of treatment options for methicillin-resistant Staphylococcus aureus infections in the obese patient

Navaneeth Narayanan,1,2 Christopher D Adams,1 David W Kubiak,3 Serena Cheng,4 Robyn Stoianovici,5 Leonid Kagan,1,6 Luigi Brunetti1,61Department of Pharmacy Practice, Rutgers University, Ernest Mario School of Pharmacy, Piscataway, NJ, USA; 2Division of Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; 3Department of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USA; 4Department of Pharmacy, VA San Diego Healthcare System, San Diego, CA, USA; 5Department of Pharmacy, University of California, Davis Medical Center, Sacramento, CA, USA; 6Department of Pharmaceutics, Rutgers University, Ernest Mario School of Pharmacy, Piscataway, NJ, USAAbstract: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major cause of infection in both the hospital and community setting. Obesity is a risk factor for infection, and the prevalence of this disease has reached epidemic proportions worldwide. Treatment of infections in this special population is a challenge given the lack of data on the optimal antibiotic choice and dosing strategies, particularly for treatment of MRSA infections. Obesity is associated with various physiological changes that may lead to altered pharmacokinetic parameters. These changes include altered drug biodistribution, elimination, and absorption. This review provides clinicians with a summary of the literature pertaining to the pharmacokinetic and pharmacodynamic considerations when selecting antibiotic therapy for the treatment of MRSA infections in obese patients.Keywords: obesity, methicillin-resistant Staphylococcus aureus, antibiotics, pharmacokinetics