title: Treatment with echinocandins during continuous renal replacement therapy.
abstract: Echinocandins are indicated as first-line treatment for invasive candidiasis in moderate to severe illness. As sepsis is the main cause of acute kidney injury, the combination of echinocandin treatment and continuous renal replacement therapy (CRRT) is common. Optimizing antibiotic dosage in critically ill patients receiving CRRT is challenging. The pharmacokinetics of echinocandins have been studied under various clinical conditions; however, data for CRRT patients are scarce. Classically, drugs like echinocandins with high protein binding and predominantly non-renal elimination are not removed by CRRT, indicating that no dosage adjustment is required. However, recent studies report different proportions of echinocandins lost by filter adsorption. Nevertheless, the clinical significance of these findings remains unclear.
authors.forename: Francisco
authors.initials: F
authors.lastname: González de Molina
authors.forename: Maria de Los Ángeles
authors.initials: Mde L
authors.lastname: Martínez-Alberici
authors.forename: Ricard
authors.initials: R
authors.lastname: Ferrer
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D058365:Candidiasis, Invasive / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D054714:Echinocandins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D017582:Renal Replacement Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins