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Fluconazole pharmacokinetics in burn patients
B A Boucher1, S R King, H L Wandschneider
1Department of Clinical Pharmacy, University of Tennessee, Memphis 38163, USA. bboucher@utmem1.utmem.edu
Antimicrobial Agents and Chemotherapy
|April 29, 1998
Summary
Severe burn patients exhibit altered fluconazole pharmacokinetics. Fluconazole (a common antifungal) shows a shorter half-life and faster clearance in burn patients compared to other populations.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Burn Medicine
Background:
- Severe burns significantly alter drug pharmacokinetics.
- Understanding fluconazole's behavior in burn patients is crucial for effective treatment.
Purpose of the Study:
- To investigate the pharmacokinetics of fluconazole in adult patients with severe burns.
- To determine fluconazole's half-life, clearance, and volume of distribution in this patient group.
Main Methods:
- Studied nine adult patients with severe burns (30-95% total body surface area).
- Assessed fluconazole pharmacokinetics on days 3 and 8 post-burn in five patients.
- Calculated pharmacokinetic parameters including half-life (t1/2), clearance (CL), and volume of distribution (V).
Main Results:
- No significant changes in t1/2, CL, or V were observed over time in patients studied on days 3 and 8.
- Mean t1/2 was 24.4 +/- 5.8 h, mean CL was 0.36 +/- 0.09 ml/min/kg, and mean V was 0.72 +/- 0.12 liters/kg.
- Fluconazole t1/2 was approximately 13% shorter and CL was 30% more rapid than in other reported populations.
Conclusions:
- Fluconazole pharmacokinetics are significantly altered in severe burn patients.
- Burn patients exhibit a shorter half-life and faster clearance of fluconazole.
- These findings suggest potential need for dose adjustments in burn patients to maintain therapeutic drug levels.