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首页> 外文期刊>Antimicrobial agents and chemotherapy. >Pharmacokinetic Properties of Micafungin in Critically Ill Patients Diagnosed with Invasive Candidiasis
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Pharmacokinetic Properties of Micafungin in Critically Ill Patients Diagnosed with Invasive Candidiasis

机译：麦克风素在患有侵袭性念珠菌病的临界病患者中的药代动力学特性

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摘要

The estimated attributable mortality rate for invasive candidiasis (IC) in the intensive care unit (ICU) setting varies from 30 to 40%. Physiological changes in critically ill patients may affect the distribution and elimination of micafungin, and therefore, dosing adjustments might be mandatory. The objective of this study was to determine the pharmacokinetic parameters of micafungin in critically ill patients and assess the probability of target attainment. Micafungin plasma concentrations were measured to estimate the pharmacokinetic properties of micafungin. MIC values for Candida isolates were determined to assess the probability of target attainment for patients. Data from 19 patients with suspected or proven invasive candidiasis were available for analysis. The median area under the concentration-time curve from 0 to 24 h at steady state (AUC(0-24)) was 89.6 mg u h/liter (interquartile range [IQR], 75.4 to 113.6 mg u h/liter); this was significantly lower than the median micafungin AUC(0-24) values of 152.0 mg u h/liter (IQR, 136.0 to 162.0 mg u h/liter) and 134.0 mg u h/liter (IQR, 118.0 to 148.6 mg . h/liter) in healthy volunteers (P = 0.0001 and P = 0.001, respectively). All Candida isolates were susceptible to micafungin, with a median MIC of 0.016 mg/liter (IQR, 0.012 to 0.023 mg/liter). The median AUC(0-24)/MIC ratio was 5,684 (IQR, 4,325 to 7,578), and 3 of the 17 evaluable patients (17.6%) diagnosed with proven invasive candidiasis did not meet the AUC/MIC ratio target of 5,000. Micafungin exposure was lower in critically ill patients than in healthy volunteers. The variability in micafungin exposure in this ICU population could be explained by the patients' body weight. Our findings suggest that healthier patients (sequential organ failure assessment [SOFA] score of 10) weighing more than 100 kg and receiving 100 mg micafungin daily are at risk for inappropriate micafungin exposure and potentially inadequate antifungal treatment.
机译：重症监护单位（ICU）设定中浸润念珠菌病（IC）的估计可应合死亡率（IC）各不相同于30％至40％。危重病患者的生理变化可能影响Micafungin的分布和消除，因此，给药调整可能是强制性的。本研究的目的是确定Micafungin在批判性患者中的药代动力学参数，并评估目标达到的可能性。测量Micafungin血浆浓度以估计Micafungin的药代动力学性质。确定念珠菌分离株的麦克风值，以评估患者的目标达到概率。来自19名可疑或经过验证的侵袭性念珠菌病的数据可用于分析。在稳态浓度 - 时间曲线下的中值区域（AUC（0-24））为89.6mg U H /升（间隙范围[IQR]，75.4至113.6mg U H /升）;这显着低于Micafungin Auc（0-24）值152.0mg /升（IQR，136.0至162.0mg /升）和134.0mg UH /升（IQR，118.0至148.6毫克.H /升）在健康的志愿者（p = <0.0001和p = <0.001）。所有Candida分离物易患Micafungin，中位MIC为0.016 mg /升（IQR，0.012至0.023 mg /升）。中位数AUC（0-24）/ MIC比率为5,684（IQR，4,325至7,578），17名可评估患者中的3名（17.6％）被诊断为已验证的侵入性念珠菌病，未达到5,000的AUC / MIC比率目标。 Micafungin暴露于危重病患者的患者患者比健康的志愿者较低。这种ICU人群中Micafungin暴露的可变性可以通过患者的体重来解释。我们的研究结果表明，更健康的患者（顺序器官衰竭评估[沙发]的评分为100公斤，每天受到100毫克的100毫克，每天受到风险，不适合麦克风素暴露，并且可能不足的抗真菌治疗。

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    Boonstra J. M.; van der Elst K. C.; Veringa A.; Jongedijk E. M.; Bruggemann R. J.; Koster R. A.; Kampinga G. A.; Kosterink J. G.; van der Werf T. S.; Zijlstra J. G.; Touw D. J.; Alffenaar J. W. C.;

  • 作者单位

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Nijmegen Radboud Univ Med Ctr Dept Pharm Nijmegen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Med Microbiol &

    Infect Prevent Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Internal Med Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Crit Care Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

    Univ Groningen Univ Med Ctr Groningen Dept Clin Pharm &

    Pharmacol Groningen Netherlands;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 治疗学;
  • 关键词

    micafungin; pharmacokinetics; invasive candidiasis; critically ill;

    机译：micafungin;药代动力学;侵入性念珠菌病;危重病;

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