Pharmacokinetics of anidulafungin in critically ill patients with candidaemia/invasive candidiasis.

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Pharmacokinetics of anidulafungin in critically ill patients with candidaemia/invasive candidiasis.

Antimicrob Agents Chemother. 2013 Jan 18;

Authors: Liu P, Ruhnke M, Meersseman W, Paiva JA, Kantecki M, Damle B

Abstract
The pharmacokinetics of intravenous anidulafungin in adult intensive care unit (ICU) patients were assessed in this study, and compared with historical data from a general patient population and healthy subjects. Intensive plasma samples were collected over a dosing interval at steady state from 21 ICU patients with candidaemia/invasive candidiasis. All patients received the recommended dosing regimen (a 200 mg loading dose on day 1, followed by 100 mg maintenance dose daily), except for a 54-year-old, 240 kg female patient (150 mg daily maintenance dose instead). Plasma samples were assayed for anidulafungin using a validated liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters in ICU patients were calculated by a non-compartmental method. Excluding the 240 kg patient, median [min, max] age, weight and body mass index (BMI) of 20 ICU patients were 57 [39, 78] years, 65 [48, 106] kg, and 23.3 [16.2, 33.8] kg/m(2), respectively. The average anidulafungin area under the curve over 24-hour dosing interval (AUC(0-24)), maximum concentration (C(max)), and clearance (CL) in 20 ICU patients were 92.7 mg⋅h/l, 7.7 mg/l, and 1.3 l/h, respectively. The exposure in the 240 kg patient at a 150 mg daily dose was within the range observed in ICU patients overall. The average AUC(0-24) and C(max) in the general patient population and healthy subjects were 110.3 and 105.9 mg⋅h/l, respectively, and 7.2 and 7.0 mg/l, respectively. The pharmacokinetics of anidulafungin in ICU patients appeared to be comparable to those in the general patient population and healthy subjects at the same dosing regimen.

PMID: 23335738 [PubMed - as supplied by publisher]