Vancomycin Dose Optimization in Obesity
An Open-Label, Single-Dose, Pharmacokinetic Study of Vancomycin Dosed by Weight or Kidney Function in Adults With Obesity
University of Michigan
24 participants
Apr 1, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to learn how to optimize vancomycin dosing in obese adults based on weight and kidney function. It will also assess the safety of different vancomycin dosing strategies. The main questions it aims to answer are: Does dosing vancomycin based on kidney function provide better drug exposure than dosing based on weight? What medical or safety issues arise when vancomycin is dosed according to weight versus kidney function? Participants will be randomized into two groups. One group will receive vancomycin doses based on their weight, while the other will receive doses based on their kidney function. Participants will: Receive a single dose of vancomycin based on either their weight or kidney function after pretreatment with antihistamines Provide blood and urine samples at specific times for pharmacokinetic analysis Undergo body composition measurements using DEXA scans and other methods Visit the clinic for physical exams, medical history, and laboratory tests
Eligibility
Inclusion Criteria4
- healthy obese participants within three obese class groups; BMI 30-34.9 kg/m2 (n=8), BMI 35-39.9 kg/m2 (n=8), and BMI ≥ 40 kg/m2 (n=8)
- Male or female adults age 18 to 50 years
- Weight ≥ 80 kg
- Estimated creatinine clearance of 60 mL/min to 119 mL/min (n=12) or ≥ 120 mL/min (n=12) (based on the Cockcroft-Gault equation and dosing weight)
Exclusion Criteria15
- Pregnant or lactating females
- Significant clinical illness within 3 weeks prior to screening
- History of severe allergic diseases including drug allergies, with the exception of seasonal allergies
- Patients initiated on GLP1 agonists
- Any other factor, condition, or disease, including but not limited to cardiovascular, renal, hepatic, or gastrointestinal disorders that may, in the opinion of the Investigator, jeopardize the safety of the participant or impact the validity of the study results.
- History of drug addiction or alcohol abuse within the past 12 months
- Any clinically significant abnormal lab values (Chemistry and Complete Blood Count) during screening
- Participants unwilling or unable to receive vancomycin by intravenous infusion
- Individuals with a history of psychiatric or neurological illness, including seizure disorders
- Systolic blood pressure less than 90 mm of Hg or more than 140 mm of Hg
- Diastolic blood pressure less than 60 mm of Hg or more than 90 mm of Hg
- Pulse rate \<50 beats/minute or \>100 beats/minute.
- History of hypersensitivity or infusion reaction to vancomycin, cetirizine, or famotidine
- Participants with underlying hearing loss
- Participants that are taking ototoxic drugs
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Interventions
Vancomycin weight-based or kidney function-based dosing
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06601257