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Broth Microdilution In Vitro Screening: An Easy and Fast Method to Detect New Antifungal Compounds
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[Experience of micafungin in patients requiring extrarenal depuration]

F Alvarez-Lerma1, S Grau, Y Díaz

  • 1Servicio de Medicina Intensiva, Hospital del Mar, Paseo Marítimo 25-29, 08003, Barcelona, Spain. Falvarez@hospitaldelmar.cat

Revista Espanola De Quimioterapia : Publicacion Oficial De La Sociedad Espanola De Quimioterapia
|December 31, 2010
PubMed
Abstract

Insights

Micafungin levels remain stable during extrarenal depuration in ICU patients. No dose adjustments are needed for this antifungal when patients undergo continuous venovenous hemodialysis or hemodiafiltration.

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Extrarenal depuration techniques are common in ICUs.
  • These procedures can lower antimicrobial plasma concentrations, including fluconazole.
  • Antifungal efficacy relies on achieving adequate drug levels at infection sites.

Purpose of the Study:

  • To review published pharmacokinetic data of micafungin in ICU patients undergoing extrarenal depuration.
  • To assess micafungin's behavior during renal replacement therapies.

Main Methods:

  • Literature review of studies on micafungin pharmacokinetics during extrarenal depuration.
  • Analysis of data from patients on continuous venovenous hemodialysis and hemodiafiltration.

Main Results:

  • Three studies were included, focusing on continuous venovenous hemodialysis and hemodiafiltration.
  • Micafungin plasma concentrations showed minimal variation pre- and post-hemofilter.
  • Negligible amounts of micafungin were found in ultrafiltration fluid.

Conclusions:

  • Dosing adjustments for micafungin are not required during extrarenal depuration in critically ill patients.
  • Micafungin maintains predictable pharmacokinetics irrespective of renal replacement therapy in the ICU setting.

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