PMID- 27068676
OWN - NLM
STAT- MEDLINE
DCOM- 20170215
LR  - 20170215
IS  - 1872-7913 (Electronic)
IS  - 0924-8579 (Linking)
VI  - 47
IP  - 5
DP  - 2016 May
TI  - Pharmacokinetic/pharmacodynamic adequacy of echinocandins against Candida spp. in 
      intensive care unit patients and general patient populations.
PG  - 397-402
LID - S0924-8579(16)30018-8 [pii]
LID - 10.1016/j.ijantimicag.2016.02.004 [doi]
AB  - This study evaluated whether contemporary echinocandin regimens achieved 
      pharmacokinetic/pharmacodynamic targets in ICU patients and general patient 
      populations (GPPs) and assessed caspofungin (CAS) regimens in hepatic impairment 
      (HI) patients. A Monte Carlo simulation was performed using previously published 
      data. Recommended dosing regimens of echinocandins in ICU patients, GPPs and 
      healthy volunteers were evaluated: 70mg loading dose then 50mg maintenance dose 
      (70/50mg) for CAS; 100mg q24h for micafungin (MCF); and 200/100mg for 
      anidulafungin (ANF). Moreover, CAS 70mg and 100mg q24h in GPPs, and CAS 70/50mg 
      and 70/35mg in mild and moderate HI patients, respectively, were evaluated. 
      Cumulative fraction of response (CFR) was calculated for each dosing regimen. For 
      Candida albicans, CFRs for the recommended doses of CAS, MCF and ANF were 95.8%, 
      13.5% and 50.5% in ICU patients and 96.3%, 42.4% and 61.6% in GPPs, respectively; 
      for Candida glabrata, CFRs were 99.4%, 90.6% and 44.6% in ICU patients and 99.5%, 
      97.1% and 59.8% in GPPs. For Candida parapsilosis, CFRs of echinocandins for 
      standard regimens were <70%; only CAS 100mg q24h achieved the target CFR. CAS 
      70/50mg and 70/35mg in mild and moderate HI patients were appropriate. 
      Considerable interindividual variability was observed. For C. albicans and C. 
      glabrata, CAS is good choice both for ICU and other patient populations, but for 
      C. parapsilosis an increased dose should be considered. For MCF and ANF, 
      administering higher doses with longer dosing intervals achieves better target 
      attainment and should be investigated in clinical trials.
CI  - Copyright (c) 2016 Elsevier B.V. and the International Society of Chemotherapy. All 
      rights reserved.
FAU - Yang, Qianting
AU  - Yang Q
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Wang, Taotao
AU  - Wang T
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Xie, Jiao
AU  - Xie J
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Wang, Yan
AU  - Wang Y
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Zheng, Xiaowei
AU  - Zheng X
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Chen, Lu
AU  - Chen L
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Li, Ying
AU  - Li Y
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Meng, Ti
AU  - Meng T
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China.
FAU - Dong, Yalin
AU  - Dong Y
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China. Electronic address: dongyalin@mail.xjtu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20160315
PL  - Netherlands
TA  - Int J Antimicrob Agents
JT  - International journal of antimicrobial agents
JID - 9111860
RN  - 0 (Antifungal Agents)
RN  - 0 (Echinocandins)
SB  - IM
MH  - Antifungal Agents/administration & dosage/*pharmacokinetics/*pharmacology
MH  - Candida/*drug effects
MH  - Candidiasis/drug therapy/*microbiology
MH  - Echinocandins/administration & dosage/*pharmacokinetics/*pharmacology
MH  - Healthy Volunteers
MH  - Humans
MH  - Intensive Care Units
MH  - Monte Carlo Method
OTO - NOTNLM
OT  - Candida
OT  - Cumulative fraction of response
OT  - Echinocandin
OT  - Intensive care unit
OT  - Pharmacokinetic/pharmacodynamic
EDAT- 2016/04/14 06:00
MHDA- 2017/02/16 06:00
CRDT- 2016/04/13 06:00
PHST- 2015/10/21 00:00 [received]
PHST- 2016/02/01 00:00 [revised]
PHST- 2016/02/14 00:00 [accepted]
PHST- 2016/04/13 06:00 [entrez]
PHST- 2016/04/14 06:00 [pubmed]
PHST- 2017/02/16 06:00 [medline]
AID - S0924-8579(16)30018-8 [pii]
AID - 10.1016/j.ijantimicag.2016.02.004 [doi]
PST - ppublish
SO  - Int J Antimicrob Agents. 2016 May;47(5):397-402. doi: 
      10.1016/j.ijantimicag.2016.02.004. Epub 2016 Mar 15.