Anidulafungin pharmacokinetics in critically ill patients M.J.

Ref ID: 17774

Author:

M.J.P. van Wanrooy*, M.G.G. Rodgers, D.R.A. Uges, J.P. Arends,
J.G. Zijlstra, T.S. van der Werf, J.G.W. Kosterink, J.W.C.
Alffenaar

Author address:

(Groningen, NL)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Objectives: Early antifungal treatment with adequate drug exposure
reduces mortality in patients with candidemia. Efficacy ofanidulafungin is driven by AUC (area under the curve)/MIC ratio. As
anidulafungin clearance is 30% higher in patients with invasive
candidiasis than in patients with oesophageal candidiasis patients at the
ICU may be at risk for underexposure. Therefore, insight in
anidulafungin pharmacokinetics in a ’’real-life’’ population of
critically ill patients is important.
Methods: We conducted a prospective open-label study in adult
patients admitted to an intensive care unit between June 2010 and
November 2011. Patients were eligible for inclusion in case of a
positive culture for Candida from a sterile site – blood or intraabdominal
fluid. Blood samples were taken just before administering
anidulafungin and at 1.5, 2, 3, 4, 6, 8, 12 and 24 hours after start of
infusion on day 3 or 4 of treatment. Anidulafungin plasma
concentrations were measured with a validated LC-MS/MS method.
The AUC was calculated using a non compartmental method.
Results: Twenty patients with a median age of 71 (IQR: 60-75) were
studied; 11 males and 9 females. Cultures for Candida were positive in
blood for seven patients and in intra-abdominal fluid for 13 patients. In
comparison with previously reported data of critically ill patients, we
observed an apparent lower exposure and clearance and longer half-life
in our patients, see Table. The volume of distribution was similar. MIC
values ranged from <0.002 to 0.02 mg/L, and AUC/MIC ratios from 3580 to 32 250. Both anidulafungin Cmax and Cmin showed a significant correlation with the anidulafungin AUC (Cmax: R = 0.854, p < 0.001; Cmin: R = 0.884, p < 0.001; Spearman correlation coefficient).

Abstract Number: NULL

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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