Pharmacokinetics of caspofungin in patients with candidaemia

Garazzino S., Baietto L., De Rosa F., D'Avolio A., Michelazzo M., Di Perri G.

Author address: 



Objectives: The knowledge of pharmacokinetic/pharmacodynamic (PK/PD) properties of antifungals and the role of therapeutic drug monitoring (TDM) in the clinical setting are still limited. Caspofungin is an antifungal belonging to the class of echinocandins and is approved as first line treatment for invasive candidiasis. Caspofungin displays a concentration-dependent activity and the AUC/MIC has been demonstrated to be the PD parameter linked with efficacy in the murine model. Aim of our study was to measure caspofungin plasmatic parameters in patients with candidemia. Methods: We studied non-obese adult patients with candidemia treated with iv caspofungin at the recommended dosage. Plasma samples for PK measurements were collected at the steady state condition, immediately before caspofungin infusion and 1, 2, 5, 9 and 24 hours after the daily dose. Caspofungin plasma concentrations were determined using a fully validated HPLC-UV method. Pharmacokinetics parameters were obtained using WinNonlin software. Cmax/MIC and AUC/MIC were calculated considering the highest MIC reported for susceptible strains. Results: Twelve patients (9 males, 3 females) were evaluated. Five patients were liver transplant recipients, 5 had hematologic malignancies and 2 had AIDS. Five out of 12 patients were infected by Candida non-albicans strains. All Candida isolates were sensitive to caspofungin according to the CLSI breakpoints (MIC

abstract No: 

P 1310

Full conference title: 

19th European Congress of Clinical Microbiology and Infectious Diseases
    • ECCMID 19th (2009)