Abstract | Background: Methods: This was a prospective multicentre observational study in ICU patients with suspected yeast IAI. All patients received an intravenous loading dose of 200 mg of anidulafungin, followed by 100 mg/day. Thirteen blood samples were drawn between day 1 and day 5 for pharmacokinetic analysis. Samples were analysed by an HPLC-tandem MS method. Demographics and SAPS2 and SOFA scores were recorded. Results: Fourteen patients with a median age (IQR) of 62 years (48-70) and with a mean BMI of 30.5 kg/m 2 were included from three centres; 57.1% were women. Their median (IQR) SAPS2 score was 54 (45-67) and their median (IQR) SOFA score was 8 (7-12). Six patients with community-acquired IAI and eight patients with nosocomial-acquired IAI were included. Twelve yeasts were isolated: six Candida albicans , two Candida glabrata , two Candida tropicalis , one Candida parapsilosis and one Candida krusei . Pharmacokinetic parameters were as follows [mean (% coefficient of variation)]: C max (mg/L) = 6.0 (29%); T max (h) = 1.6 (25.8%); C min (mg/L) = 3.2 (36.8%); AUC 0-24 (mg·h/L) = 88.9 (38.6%); t 1/2 (h) = 42.1 (68.2%); CL (L/h) = 1.2 (42.3%); and V (L) = 72.8 (87.8%). A two-compartment model best described the anidulafungin concentrations in the population pharmacokinetic study. Conclusions: The pharmacokinetic parameters of anidulafungin in critically ill ICU patients with complicated IAI are similar to those observed in the literature. However, an increased V and a longer t 1/2 were observed in this study. (EudraCT No. 2010-018695-25).
|
Authors | H Dupont, L Massias, B Jung, N Ammenouche, P Montravers |
Journal | The Journal of antimicrobial chemotherapy
(J Antimicrob Chemother)
Vol. 72
Issue 5
Pg. 1429-1432
(05 01 2017)
ISSN: 1460-2091 [Electronic] England |
PMID | 28088767
(Publication Type: Journal Article, Multicenter Study, Observational Study)
|
Copyright | © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: [email protected]. |
Chemical References |
- Antifungal Agents
- Echinocandins
- Anidulafungin
|
Topics |
- Administration, Intravenous
- Aged
- Anidulafungin
- Antifungal Agents
(administration & dosage, blood, pharmacokinetics, therapeutic use)
- Candida
(drug effects, isolation & purification)
- Candida albicans
(drug effects, isolation & purification)
- Candida glabrata
(drug effects, isolation & purification)
- Candida tropicalis
(drug effects, isolation & purification)
- Candidiasis
(drug therapy, microbiology)
- Chromatography, High Pressure Liquid
- Critical Illness
- Echinocandins
(administration & dosage, blood, pharmacokinetics, therapeutic use)
- Female
- Humans
- Intensive Care Units
- Intraabdominal Infections
(drug therapy, microbiology)
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Prospective Studies
|