Pharmacokinetic Study Of Anidulafungin In Icu Patients With Complicated Intra-abdominal Infection

Ref ID: 19292

Author:

H. Dupont, P. Montravers, B. Jung, L. Massias

Author address:

Pole d’Anesthesie-Reanimation, CHU d’Amiens, Amiens, FRANCE, Anesthesie-Reanimation, CHU Bichat, Paris, FRANCE, Anesthesie-Reanimation, CHU Saint Eloi, Montpellier, FRANCE, Pharamcie, CHU Bichat, Paris, FRANCE.

Full conference title:

53rd Interscience Conference on Antimicrobial Agents and Chemotherapy

Date: 10 September 2014

Abstract:

Background: Pharmacokinetic (PK) data of anidulafungin in ICU are scarce, especially in patients treated for severe intra-abdominal infection (IAI). Methods: Prospective multicenter observational study including patients with suspected yeast IAI in the ICU. Patients all received an anidulafungin loading dose of 200mg IV then 100mg/j. 13 blood samplings were performed between day 1 and day 5 for the PK analysis. Samples were analyzed using a high-performance liquid chromatography-tandem mass spectrometric method. Demographics, SAPS2 and SOFA scores were noted. Results: 14 patients were included in 3 centers. Their median age [interquartile range] was 62 years [48-70], 57,1% of women, with a BMI of 30,5 kg/m-2. Their SAPS 2 score was 54 [45-67] and SOFA score of 8 [7-12]. Six community-acquired and 8 nosocomial IAI were included. Twelve yeasts were isolated: 6 Candida albicans, 2 C glabrata, 2 C tropicalis, 1 C parapsilosis and 1 C krusei. Steady-state mean concentrations of anidulafongine are exposed in the figure. PK parameters were the following (mean (% coefficient of variation)): Cmax (mg/l)=6.0 (29%) ; Tmax (h)=1.6 (25.8%) ; Cmin (mg/l)=3.2 (36.8%) ; AUC0-24h (mg.h/l) = 88.9 (38.6%) ; T1/2 (h) = 42.1 (68.2%) ; Cl (L/h)=1.2 (42.3%) and Vss (L)=72.8
(87.8%). A 2 compartments’ model was found in the
population PK study. Conclusions: PK parameters of
anidulafungin in severe ICU patients with complicated IAI
are close to that observed in healthy volunteers. However,
an increase of the volume of distribution and half-life was found in this study.

Abstract Number: NULL

Conference Year: 2013

Link to conference website: NULL

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