Recent reports indicate that patients larger in size may need higher doses of antibiotics instead of the regular dose. The ‘one size fits all’ idea for prescribing medicine may not treat infection in obese people and only develop more resistance in the body. One of The Lancet’s narrative review brought this concern into light. The review discussed several pressing issues about drug treatments. Authors of the review indicated the need for proportional prescriptions. Simply, authors proposed the prescription of drugs and doses according to the person’s body weight. The same way is used in prescribing drugs to children.

It was raised that when drug doses and prescriptions are relative to the patient’s body weight, it will be more advantageous for the condition of the patient. It was also noted that comparative prescription may make it easier to fight diseases in general. The major concern in this matter is the build up of microbes that are resistant to antivirals, antibiotics, or antifungals. Given that individual prescription can help avert resistance, then healthcare professionals should consider this method.

However, changing existing prescribing practice will have significant implications in practice and cost. These factors should be carefully considered. There is a need to further conduct trials before implementing the proposed method in a wider scale. The results of trials will determine if the benefits outweighs the costs and implications of changing current practice.

Discussion points of the proposal

The authors of the review indicate that even though pharmacokinetic studies (studies about drug processes and distribution) take into consideration age differences and variations of the disease, it is important to consider other characteristics such as body size.

The physiological alterations observed in the body like increased adipose (fat) tissue, tend to influence metabolism, distribution, as well as clearance of drugs in the body. More specifically, there should be careful consideration to hydrophilic (’water-loving’) as well as lipophilic (’fat-loving’) drugs. The distribution of these two drugs differs for lean and obese individuals. The size of the person’s body can also influence kidney and liver functions. These functions affect the clearance of drugs in the body.

Available data confirm the prescribing according to body size helps achieve desired outcomes in the body. Nonetheless, further research is still needed to fully verify the effects of comparative prescription as opposed to current practices. Successful clinical trials are needed to determine the extent of the method’s effects.

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