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- Title
Impact of Bariatric Surgery on the Pharmacokinetics Parameters of Amoxicillin.
- Authors
Rocha, Marina Becker Sales; Rohleder, Andrea Vieira Pontes; Fechine, Francisco Vagnaldo; do Nascimento, Demetrius Fernandes; de Moraes, Manoel Odorico; de Moraes, Maria Elisabete Amaral; De Nucci, Gilberto; Antunes, Natalícia J.; Lemos, Francisco Ney; de Albuquerque Lima Babadopulos, Rodrigo Feitosa; Mendes, Gustavo D.
- Abstract
Background: Bariatric surgery leads to several anatomo-physiological modifications that may affect pharmacokinetic parameters and consequently alter the therapeutic effect of drugs, such as antibiotics. The pharmacokinetics of oral amoxicillin after Roux-en-Y gastric bypass (RYGB) surgery is unknown.Objectives: The objective of this study was to evaluate the impact of bariatric surgery on the pharmacokinetics of amoxicillin.Methods: This study was performed as a randomized, open-label, single-dose clinical trial, with two periods of treatment, in which obese subjects (n = 8) received an amoxicillin 500 mg capsule orally before and 2 months after the RYGB surgery. The amoxicillin plasma concentration was determined by liquid chromatography coupled to mass spectrometry (LC-MS/MS).Results: After the surgery, the mean weight loss was 17.03 ± 5.51 kg, and mean body mass index (BMI) decreased from 46.21 ± 2.82 to 38.82 ± 3.32 kg/m2. The mean amoxicillin area under the plasma concentration versus time curve from time zero to the time of the last quantifiable concentration (AUC0-tlast) increased significantly (3.5-fold); the maximum plasma concentration (Cmax) increased 2.8-fold after the bariatric surgery. No correlation was found between amoxicillin absorption, BMI, and weight loss percentage.Conclusion: The alterations observed in the amoxicillin pharmacokinetics suggest that obese subjects included in this trial had a substantially increase in amoxicillin systemic exposure after RYGB surgery. However, despite this increase, its exposure was lower than the values reported for non-obese volunteers.Trial Registration: Identifiers: NCT03588273
- Subjects
BARIATRIC surgery; GASTRIC bypass; CLAVULANIC acid; AMOXICILLIN; PHARMACOKINETICS; BODY mass index; WEIGHT loss
- Publication
Obesity Surgery, 2019, Vol 29, Issue 3, p917
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-018-3591-3