Related Experiment Video

Updated: Aug 19, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Electronic-nomogram-guided micafungin dosing regimen in critically ill patients: A population pharmacokinetic study

Jean-Joseph Bendjilali-Sabiani1, Ahlem Gammoudi2, Matthieu Conseil3

  • 1Service of Medical Pharmacology and Toxicology, Montpellier University Hospital, Montpellier, France; PCCEI, University Montpellier, INSERM, University Antilles, Montpellier, France.

International Journal of Antimicrobial Agents
|August 17, 2026
PubMed
Abstract

Insights

Optimizing micafungin dosing for invasive candidiasis in critically ill patients is crucial. A population pharmacokinetic model and electronic nomogram were developed to guide personalized dosing, improving treatment efficacy.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Micafungin is a first-line treatment for invasive candidiasis.
  • Optimal dosing in critically ill patients is unclear due to pharmacokinetic variability.

Purpose of the Study:

  • Develop a population pharmacokinetic (popPK) model for micafungin.
  • Create an electronic nomogram for optimal initial dosing regimen selection.

Main Methods:

  • Retrospective monocentric pharmacokinetic study in a digestive ICU.
  • Population pharmacokinetic modeling and covariate analysis using Monolix.
  • Monte Carlo simulations to build an electronic nomogram.

Main Results:

  • A linear one-compartment model described micafungin pharmacokinetics.
  • Total body weight and total bilirubin influenced volume of distribution and clearance.
  • Current 100 mg/day regimen may be insufficient for some Candida species.

Conclusions:

  • Developed a popPK model and electronic nomogram for micafungin dosing.
  • The tool aids clinicians in selecting optimal loading and maintenance doses.
  • Aims to maximize the probability of achieving pharmacokinetic/pharmacodynamic targets.
Keywords:
AntifungalMass spectrometryMicafunginPopulation pharmacokineticsTherapeutic drug monitoring

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