Related Experiment Video

Updated: May 4, 2026

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
09:52

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis

Published on: March 9, 2018

12.7K

Insufficient serum caspofungin levels in a paediatric patient on ECMO

Birgit C P Koch1, Enno D Wildschut2, Anna L de Goede1

  • 1Hospital Pharmacy Erasmus MC, PO box 2040, 3000 CA, Rotterdam, The Netherlands.

Medical Mycology Case Reports
|January 17, 2014
PubMed

Insights

This study found that a pediatric patient on extracorporeal membrane oxygenation (ECMO) experienced subtherapeutic caspofungin levels. Therapeutic drug monitoring is recommended for antifungal dosing in children undergoing ECMO.

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Pediatrics

Background:

  • Caspofungin is a lipophilic echinocandin antifungal agent.
  • Pharmacokinetics of caspofungin in pediatric populations are not well-established.
  • Extracorporeal membrane oxygenation (ECMO) can alter drug pharmacokinetics.

Purpose of the Study:

  • To investigate the pharmacokinetics of caspofungin in a pediatric patient receiving ECMO.
  • To assess caspofungin exposure in a critically ill child with severe pneumonia and sepsis on ECMO.

Main Methods:

  • Case report of a pediatric patient on ECMO.
  • Administration of caspofungin at normal to high dosages.
  • Monitoring of caspofungin drug levels.

Main Results:

  • The patient exhibited subtherapeutic exposure to caspofungin.
  • Despite adequate dosing, drug levels remained below therapeutic targets.
  • ECMO support potentially impacted caspofungin pharmacokinetics.

Conclusions:

  • Therapeutic drug monitoring for caspofungin is crucial in pediatric patients on ECMO.
  • Standard dosing may not achieve therapeutic concentrations in this population.
  • Further research is needed to optimize antifungal dosing strategies during ECMO.

Keywords:
AspergillosisCandidiasisPharmacokineticsPneumoniaTherapeutic drug monitoring

More Related Videos

Automation of Bio-Atomic Force Microscope Measurements on Hundreds of C. albicans Cells09:27

Automation of Bio-Atomic Force Microscope Measurements on Hundreds of C. albicans Cells

Published on: April 2, 2021

3.3K
Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance08:45

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance

Published on: December 28, 2017

11.9K

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
408
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.8K
Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to...
119
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
768
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
1.4K