![]() The penetration into subcutaneous tissue was investigated using the microdialysis technique, which allows the determination of free drug in interstitial fluid (ISF), a major site of bacterial infections. 2 The aim of the present study was to provide data on the plasma and tissue pharmacokinetics following an intravenous single short infusion of 8 g of fosfomycin in obese patients undergoing bariatric surgery and, for comparison, in non-obese patients undergoing major intra-abdominal surgery. The small, hydrophilic molecule (molecular weight 138.06 g/mol) exhibits negligible protein binding and, following intravenous administration, 93%–99% is excreted unchanged in the urine. ![]() ![]() 1 Fosfomycin is an antibiotic with a phosphonic acid structure, chemically unrelated to any other known antibacterial agent, and exhibits activity against a broad spectrum of Gram-positive and Gram-negative bacteria, including multiresistant strains. 1 However, changes in both V and CL due to physiological changes in obesity have been observed. As a result, information regarding the impact of obesity on the pharmacokinetics and pharmacodynamics of the majority of drugs remains limited. Unfortunately, obese subjects are underrepresented in clinical trials during the drug development process. With the rise in obesity worldwide, clinicians encounter obese patients with increasing frequency in their daily practice.
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