Vancomycin obesity

A morbidly obese 17-year-old Hispanic girl, who had a cadaveric renal transplantation 5 years before, took ciclosporin and prednisone for stabilization. She was treated with chloramphenicol 875 mg qds and ceftazidime 2 g tds for vancomycin-resistant enterococcal sinusitis. There was a substantial and sustained increase in ciclosporin concentrations after chloramphenicol was added. Normalization was achieved after withdrawal of chloramphenicol. 

Blouin RA, Bauer LA, Miller DD, el al. Vancomycin pharmacokinetics in normal and morbidly obese subjects. Antimicrob Agents Chemother 1982 21 575-580. 

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