Pharmacokinetics of anidulafungin in critically ill intensive care unit patients with suspected or proven invasive fungal infections
| Autor: | Peter Pickkers, A.R.J. Girbes, V. Middel-Baars, Angela Colbers, E. L. Swart, Roger J. M. Brüggemann, Dylan W. de Lange |
|---|---|
| Přispěvatelé: | Clinical pharmacology and pharmacy, Intensive care medicine, ACS - Diabetes & metabolism, AII - Infectious diseases |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Antifungal Agents Critical Illness 030106 microbiology Cmax lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] Anidulafungin Gastroenterology law.invention 03 medical and health sciences Cmin Echinocandins Blood serum Interquartile range law Internal medicine medicine Humans Pharmacology (medical) Aged Volume of distribution Aged 80 and over Pharmacology business.industry Liter Middle Aged Intensive care unit Healthy Volunteers Intensive Care Units Infectious Diseases lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Anesthesia Female business Invasive Fungal Infections medicine.drug |
| Zdroj: | Antimicrobial Agents and Chemotherapy, 61(2):e01894. American Society for Microbiology Antimicrobial Agents and Chemotherapy, 61, UNSP e01894-16-UNSP e01894-16 Antimicrobial Agents and Chemotherapy, 61, 2, pp. UNSP e01894-16-UNSP e01894-16 Brüggemann, R J M, Middel-Baars, V, De Lange, D W, Colbers, A, Girbes, A R J, Pickkers, P & Swart, E L 2017, ' Pharmacokinetics of anidulafungin in critically ill intensive care unit patients with suspected or proven invasive fungal infections ', Antimicrobial Agents and Chemotherapy, vol. 61, no. 2, e01894 . https://doi.org/10.1128/AAC.01894-16 |
| ISSN: | 0066-4804 |
| DOI: | 10.1128/AAC.01894-16 |
| Popis: | Echinocandins, such as anidulafungin, are the first-line treatment for candidemia or invasive candidiasis in critically ill patients. There are conflicting data on the pharmacokinetic properties of anidulafungin in intensive care unit (ICU) patients. Adult ICU patients (from 3 hospitals) receiving anidulafungin for suspected or proven fungal infections were included in the present study. Patients were considered evaluable if a pharmacokinetic curve for day 3 could be completed. Twenty-three of 36 patients (7 female and 16 male) were evaluable. The median (range) age and body weight were 66 (28 to 88) years and 76 (50 to 115) kg, respectively. Pharmacokinetic sampling on day 3 ( n = 23) resulted in a median anidulafungin area under the concentration-time curve from 0 to 24 h (AUC 0–24 ) of 72.1 (interquartile range [IQR], 61.3 to 94.0) mg · h · liter −1 , a median daily trough concentration ( C 24 ) of 2.2 (IQR, 1.9 to 2.9) mg/liter, a median maximum concentration of drug in serum ( C max ) of 5.3 (IQR, 4.1 to 6.0) mg/liter, a median volume of distribution ( V ) of 46.0 (IQR, 32.2 to 60.2) liters, and a median clearance (CL) of 1.4 (IQR, 1.1 to 1.6) liters · h −1 . Pharmacokinetic sampling on day 7 ( n = 13) resulted in a median AUC 0–24 of 82.7 (IQR, 73.0 to 129.5) mg · h · liter −1 , a median minimum concentration of drug in serum ( C min ) of 2.8 (IQR, 2.2 to 4.2) mg/liter, a median C max of 5.9 (IQR, 4.6 to 8.0) mg/liter, a median V of 39.7 (IQR, 32.2 to 54.4) liters, and a median CL of 1.2 (IQR, 0.8 to 1.4) liters · h −1 . The geometric mean ratio for the AUC day7 /AUC day3 term was 1.13 (90% confidence interval [CI], 1.03 to 1.25). The exposure in the ICU patient population was in accordance with previous reports on anidulafungin pharmacokinetics in ICU patients but was lower than that for healthy volunteers or other patient populations. Larger cohorts of patients or pooled data analyses are necessary to retrieve relevant covariates. (This study has been registered at ClinicalTrials.gov under identifier NCT01438216.) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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