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Case Reports in Critical Care
Volume 2017, Article ID 5310768, 3 pages
Case Report

Dosing of Ertapenem in an Extreme Obesity: A Case Report of 250 kg Patient

1Tartu University Hospital Pharmacy, Tartu, Estonia
2Department of Microbiology, University of Tartu, Tartu, Estonia
3Clinic of Anaesthesiology and Intensive Care, Tartu University Hospital, Tartu, Estonia
4Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia
5Institute of Chemistry, University of Tartu, Tartu, Estonia
6Analytical Services International, St George’s University of London, London, UK

Correspondence should be addressed to Jana Lass; ee.mukiniilk@ssal.anaj

Received 26 June 2017; Accepted 7 September 2017; Published 8 October 2017

Academic Editor: Mehmet Doganay

Copyright © 2017 Jana Lass et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Limited available data for dosing in obesity of the medicines used in this case are discussed, with the emphasis on ertapenem. The case illustrates the difficulties in dosing medicines to morbidly overweight patients. The number of such patients is increasing but data on adequate doses of medicines are scarce. We demonstrate that ertapenem 1,5 g i.v. once daily provided adequate drug exposure for susceptible bacteria in a 250 kg patient with normal renal function. The case suggests the usefulness of therapeutic drug monitoring of antibiotics, especially in critically ill patients.