title: Pharmacokinetics of anidulafungin in critically ill patients with candidemia/invasive candidiasis.
abstract: The pharmacokinetics of intravenous anidulafungin in adult intensive care unit (ICU) patients were assessed in this study and compared with historical data from a general patient population and healthy subjects. Intensive plasma sampling was performed over a dosing interval at steady state from 21 ICU patients with candidemia/invasive candidiasis. All patients received the recommended dosing regimen (a 200-mg loading dose on day 1, followed by a daily 100-mg maintenance dose), except for a 54-year-old 240-kg female patient (who received a daily 150-mg maintenance dose instead). Plasma samples were assayed for anidulafungin using a validated liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters in ICU patients were calculated by a noncompartmental method. With the exclusion of the 240-kg patient, the median (minimum, maximum) age, weight, and body mass index (BMI) of 20 ICU patients were 57 (39, 78) years, 65 (48, 106) kg, and 23.3 (16.2, 33.8) kg/m(2), respectively. The average anidulafungin area under the curve over the 24-hour dosing interval (AUC(0-24)), maximum concentration (C(max)), and clearance (CL) in 20 ICU patients were 92.7 mg · h/liter, 7.7 mg/liter, and 1.3 liters/h, respectively. The exposure in the 240-kg patient at a daily 150-mg dose was within the range observed in ICU patients overall. The average AUC(0-24) and Cmax in the general patient population and healthy subjects were 110.3 and 105.9 mg · h/liter and 7.2 and 7.0 mg/liter, respectively. The pharmacokinetics of anidulafungin in ICU patients appeared to be comparable to those in the general patient population and healthy subjects at the same dosing regimen.
authors: Clinical Pharmacology, Specialty Care, Pfizer Inc, Groton, Connecticut, USA.
authors: Ping
authors: P
authors: Liu
authors: Markus
authors: M
authors: Ruhnke
authors: Wouter
authors: W
authors: Meersseman
authors: José Artur
authors: JA
authors: Paiva
authors: Michal
authors: M
authors: Kantecki
authors: Bharat
authors: B
authors: Damle
mesh_terms: D000328:Adult; D000368:Aged; D000077612:Anidulafungin; D000935:Antifungal Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D058387:Candidemia / Q000097:blood / Q000188:drug therapy*; D058365:Candidiasis, Invasive / Q000097:blood / Q000188:drug therapy*; D016638:Critical Illness; D054714:Echinocandins / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D000077612:Anidulafungin