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Introduction Recent estimates of the incidence aciclovir-induced AKI vary between 10.5-21%. Obesity and higher daily dosing have been suggested as a risk factors for AKI and the BNF recommends using Ideal Body Weight (IBW)-adjusted dosing for patients who are obese.Objectives Evaluate the incidence of aciclovir-induced AKIAudit dosing based on IBW in obese patientsMethods Retrospective cohort study of 410 patients over 16 years old prescribed IV aciclovir for suspected viral encephalitis at a London healthcare trust between 2021 and 2024.Results Data regarding IBW and dosing was available for 309 patients. 113/309 (37%) were identified as obese, of which 102/113 (90%) were prescribed aciclovir doses higher than their IBW-adjusted dose. We found an incidence of aciclovir-induced AKI of 44/410 (11%), of which 33 patients had IBW and dosing data available. 17/33 (52%) were identified as obese and were prescribed on average 184mg above their IBW-adjusted dose (SD 311mg), compared to 169mg (SD 179mg) for obese patients without AKI.Conclusions and recommendations Dosing is currently not being adjusted for IBW in patients who are obese. There is need for education regarding the use if IBW-adjusted dosing for patients prescribed IV aciclovir who are obese to reduce incidence of AKI.a.wakelin@hotmail.co.uk