The differences in total clearance (CLS) may increase less than proportional to weight in obese children greater than 6-year-olds, while volume of distribution at steady state increases more than proportional to weight in all obese children compared with nonobese children.

Weight-based dosing in obese children may cause an increase in steady-state concentration while prolonging the time to steady state.

Exploring alternative dosing strategies for obese children is warranted.

Overall, 4,376 patients were included, with 807 (18.4%) classified as obese children.

The majority (52.9%) were male, with a median age of 8.1 years.

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