Without more attention, the issue may only get worse, and its not just a U.S. phenomenon. The World Health Organization estimates that 400 million people were obese in 2005 and that the total will increase to 700 million by 2015. It considers these numbers a global pandemic that is affecting low, middle and high-income nations around the world. Obesity is also considered an independent risk factor for surgical site infections and is associated with higher mortality rates in critically ill patients.
Even if the problem is carefully considered, Bearden said, its not simple.
It would be nice if we could just use a simple multiplier to adjust drug dosages for overweight people, Bearden said. But its not that easy. There are a lot of factors that affect drug distribution in the body, including age, weight, kidney function, other disease problems and the type of antibiotic or other drug.
Adipose tissue, or body fat, affects how the human body interacts with drugs. With some drugs it absorbs large amounts of a prescription medication, but with others, it doesnt. And sometimes there is a very fine line between a drug being effective at one dose, ineffective if the dose is too low, and toxic if its too high. All of these issues affect appropriate dosages, and in many situations, the data needed to evaluate the problem simply doesnt exist.
The issue of adjusted drug dosages has been known and addressed in children for decades, experts say, because of the obvious distinction between a 30-pound toddler and a 120-pound youngster. But with adults, far less attention has been given the problem. The medical and pharmaceutical industries often just assume that everyone weighs about 150-170 pounds.
This is enough of an issue that if I were a very obese person being given an antibiotic, I would discuss it with my doctor, Bearden said. Hopefully the doctor will already ha
|Contact: David Bearden|
Oregon State University