title: Pharmacokinetic characteristics of caspofungin in two pediatric liver transplant patients.
abstract: BACKGROUND
  The pharmacokinetic characteristics of the antifungal drug caspofungin have not been reported in children.
  
  
  OBJECTIVE
  The aim of this study was to report limited caspofungin pharmacokinetic data for pediatric liver transplant patients.
  
  
  METHODS
  Two pediatric liver transplant patients, aged 5 years (not dialyzed) and 9 months (dialyzed), were assessed. Using a novel, validated, liquid-phase extraction with high-performance liquid chromatography, we measured plasma caspofungin concentrations from blood samples obtained within a 24-hour period after the patients were given 1 mg/kg IV of caspofungin.
  
  
  RESULTS
  Noncompartmental analysis for the nondialyzed patient showed an elimination half-life of 10.7 hours, a volume of distribution of 0.11 L/kg, and a systemic clearance of 0.12 mL/min/kg. Liver enzyme activities increased briefly; the increase may have been due to concomitant graft rejection. For the dialyzed patient, the half-life was 11.7 hours, with an adjusted volume of distribution of 0.18 L/kg and a systemic clearance of 0.24 mL/min/kg. No clinically relevant treatment-related adverse events were noted.
  
  
  CONCLUSIONS
  Pharmacokinetic data found in the 2 patients in this study are similar to those reported in adults. Until more thorough data are published, caspofungin 1 mg/kg may be considered a reasonable, tolerable dose for children.
authors.affiliation: Division of Pediatric Infectious Diseases and.
authors.forename: Michael
authors.initials: M
authors.lastname: Neely
authors.affiliation: Division of Pediatric Critical Care and Pharmacology, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Blumer
keywords: caspofungin; child; liver transplant; pharmacokinetics