title: Evaluation of Sulfobutylether-β-Cyclodextrin Exposure in a Critically Ill Patient Receiving Intravenous Posaconazole While Undergoing Continuous Venovenous Hemofiltration.
abstract: We present a 31-year-old female who had undergone an allogeneic bone marrow transplantation and who was started on intravenous posaconazole for pulmonary mycosis while undergoing continuous venovenous hemofiltration (CVVH). We performed steady-state pharmacokinetic evaluations for both posaconazole and sulfobutylether-β-cyclodextrin (SBECD). SBECD was effectively removed by CVVH, with observed exposure similar to that for patients with moderate renal impairment. Intravenous posaconazole at standard doses may be utilized in critically ill patients undergoing CVVH without significant risk of SBECD accumulation.
authors.affiliation: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA.
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Morris
authors.affiliation: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Mueller
authors.affiliation: Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Rower
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
authors.forename: Taylor
authors.initials: T
authors.lastname: Washburn
authors.affiliation: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA ty.kiser@ucdenver.edu.
authors.forename: Tyree H
authors.identifier: http://orcid.org/0000-0001-7415-3999
authors.initials: TH
authors.lastname: Kiser
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D016638:Critical Illness / Q000628:therapy*; D003505:Cyclodextrins / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D006440:Hemofiltration; D006801:Humans; D014230:Triazoles / Q000008:administration & dosage / Q000097:blood*; D047392:beta-Cyclodextrins / Q000008:administration & dosage / Q000097:blood*
chemical_list: D003505:Cyclodextrins; D014230:Triazoles; D047392:beta-Cyclodextrins; C093196:SBE4-beta-cyclodextrin; C101425:posaconazole