Intensive care unit (ICU) patients are especially at risk for invasive candidiasis due to the presence of risk factors. It is known that in critically ill patients, alterations in function of various organs and body systems can influence the pharmacokinetics and hence the plasma concentration of a drug. A study of caspofungin in ICU patients has found a high inter- and intra-individual variability in caspofungin concentration. Factors that caused subtherapeutic caspofungin plasma concentrations were body weight \> 75 kg and hypoalbuminemia. Furthermore, an efficacy study showed a lower response rate for caspofungin among patients with a higher disease severity score. As a result of the altered pharmacokinetics, under- or over-exposure of caspofungin can occur in critically ill patients and an adjusted dosage might be necessary in these patients.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
University Medical Centre Groningen
Groningen, Provincie Groningen, Netherlands
The optimal dosage of caspofungin in relation to adequate exposure (measured as AUC) in critically ill patients.
Time frame: 7 days
Pharmacokinetic parameters of caspofungin in critically ill patients.
Time frame: 3 days
Correlation of pharmacokinetic parameters and the plasma concentration of caspofungin with disease severity scores.
Time frame: 3 days
Correlation of the plasma concentration of caspofungin with candida eradication.
Time frame: 28 days
Correlation of the plasma concentration of caspofungin with inflammation parameters.
Time frame: 3 days
AUC/MIC ratio and highest observed plasma concentration (Cmax)/MIC ratio.
Time frame: 7 days
Constructing a pharmacokinetic model of caspofungin in critically ill patients.
Time frame: 28 days
Drug-related adverse events of caspofungin.
Time frame: 28 days
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