title: [Experience of micafungin in patients requiring extrarenal depuration].
abstract: BACKGROUND
  The use of extrarenal depuration techniques is increasingly frequent in patients admitted to the ICU. The use of these procedures has been related to a decrease in plasma concentrations of several antimicrobials, among which fluconazole. The activity of antifungal agents depends on achievement on adequate concentrations in plasma and at the site of infection. Micafungin is a new antifungal drug recently introduced in our country.
  
  
  OBJECTIVE
  To review the published experience of pharmacokinetic (PK) parameters of micafungin in patients requiring some type of extrarenal depuration procedures during their stay in the ICU.
  
  
  RESULTS
  Three studies with data on PK parameters of micafungin during the use of this drug in continuous venovenous hemodialysis (2 publications) and continuous hemodiafiltration (1 publication) were retrieved. In all of them, minimal variations in the plasma concentration of micafungin at the entry and exit sites of the hemofilter and a negligible or minimal presence of micafungin in the ultrafiltration fluid were demonstrated.
  
  
  CONCLUSIONS
  Adjustment of the doses or the interval between doses of micafungin during the use of extrarenal depuration techniques in critically ill patients admitted to the ICU is not necessary.
authors.affiliation: Servicio de Medicina Intensiva, Hospital del Mar, Paseo Marítimo 25-29, 08003, Barcelona, Spain. Falvarez@hospitaldelmar.cat
authors.forename: F
authors.initials: F
authors.lastname: Alvarez-Lerma
authors.forename: S
authors.initials: S
authors.lastname: Grau
authors.forename: Y
authors.initials: Y
authors.lastname: Díaz
authors.forename: J
authors.initials: J
authors.lastname: Fernández
mesh_terms: D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D003422:Critical Care; D016638:Critical Illness; D054714:Echinocandins / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D005658:Fungi / Q000187:drug effects; D017583:Hemodiafiltration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D055666:Lipopeptides / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000077551:Micafungin; D009181:Mycoses / Q000150:complications* / Q000517:prevention & control*; D006435:Renal Dialysis; D017582:Renal Replacement Therapy
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin