Dosing Medications in Obese Children

Obese children have different body composition and physiologic functions than nonobese children. In theory, these differences could affect the pharmacokinetics (PK) of their medications due to alterations in drug absorption, clearance, volume of distribution (V_d), and other parameters.

In a systematic review, researchers identified 20 studies of drug PK and dosing in obese or overweight children, including data on 21 medications. Most studies included ≤10 obese children, and most of the drugs are of greatest interest to hospitalist or specialist pediatricians (e.g., parenteral antibiotics, anticonvulsants, antineoplastics).

Of 13 drugs studied in both obese and nonobese children, differential drug exposure between groups was observed in 5 stu…