title: Insufficient serum caspofungin levels in a paediatric patient on ECMO.
abstract: Caspofungin, aechinocandin, is a relatively new lipophilic antifungal drug. Little is known concerning the pharmacokinetics of caspofungin in children. Extracorporeal membrane oxygenation (ECMO) allows prolonged cardiopulmonary support in patients with life-threatening respiratory or cardiac failure. Pharmacokinetics may be altered by ECMO. We describe the case of a paediatric patient on ECMO with severe pneumonia and sepsis, who had subtherapeutic exposure of caspofungin despite normal to high dosages of caspofungin. Therapeutic drug monitoring is warranted.
authors.affiliation: Hospital Pharmacy Erasmus MC, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Birgit C P
authors.initials: BC
authors.lastname: Koch
authors.affiliation: Pediatric Intensive Care, Erasmus MC Sophia Children's hospital, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Enno D
authors.initials: ED
authors.lastname: Wildschut
authors.affiliation: Hospital Pharmacy Erasmus MC, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Anna L de
authors.initials: AL
authors.lastname: Goede
authors.affiliation: Pediatric Intensive Care, Erasmus MC Sophia Children's hospital, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Matthijs de
authors.initials: Md
authors.lastname: Hoog
authors.affiliation: Clinical Pharmacy and Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Nijmegen Medical Centre, PO box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Roger J M
authors.initials: RJ
authors.lastname: Brüggemann
keywords: Aspergillosis; Candidiasis; Pharmacokinetics; Pneumonia; Therapeutic drug monitoring