Treatment with echinocandins during continuous renal replacement therapy.

Abstract

Echinocandins are indicated as first-line treatment for invasive candidiasis in moderate to severe illness. As sepsis is the main cause of acute kidney injury, the combination of echinocandin treatment and continuous renal replacement therapy (CRRT) is common. Optimizing antibiotic dosage in critically ill patients receiving CRRT is challenging. The pharmacokinetics of echinocandins have been studied under various clinical conditions; however, data for CRRT patients are scarce. Classically, drugs like echinocandins with high protein binding and predominantly non-renal elimination are not removed by CRRT, indicating that no dosage adjustment is required. However, recent studies report different proportions of echinocandins lost by filter adsorption. Nevertheless, the clinical significance of these findings remains unclear.

• Authors: Francisco González de Molina, Maria de Los Ángeles Martínez-Alberici, Ricard Ferrer
• Journal: Critical care (London, England) (Crit Care) Vol. 18 Issue 2 Pg. 218 (Mar 28 2014) ISSN: 1466-609X [Electronic] England
• PMID: 25029596 (Publication Type: Journal Article, Review)

Chemical References

• Antifungal Agents
• Echinocandins

Topics

• Acute Kidney Injury (diagnosis, epidemiology, therapy)
• Antifungal Agents (administration & dosage, pharmacokinetics)
• Candidiasis, Invasive (diagnosis, epidemiology, therapy)
• Combined Modality Therapy (methods)
• Critical Illness (epidemiology, therapy)
• Echinocandins (administration & dosage, pharmacokinetics)
• Humans
• Renal Replacement Therapy (methods)
• Treatment Outcome