title: Pharmacokinetic study of anidulafungin in ICU patients with intra-abdominal candidiasis.
abstract: Only limited pharmacokinetic data are available for anidulafungin in ICU patients, especially in patients treated for severe intra-abdominal infection (IAI).
  
  
  
  This was a prospective multicentre observational study in ICU patients with suspected yeast IAI. All patients received an intravenous loading dose of 200 mg of anidulafungin, followed by 100 mg/day. Thirteen blood samples were drawn between day 1 and day 5 for pharmacokinetic analysis. Samples were analysed by an HPLC-tandem MS method. Demographics and SAPS2 and SOFA scores were recorded.
  
  
  
  Fourteen patients with a median age (IQR) of 62 years (48-70) and with a mean BMI of 30.5 kg/m 2 were included from three centres; 57.1% were women. Their median (IQR) SAPS2 score was 54 (45-67) and their median (IQR) SOFA score was 8 (7-12). Six patients with community-acquired IAI and eight patients with nosocomial-acquired IAI were included. Twelve yeasts were isolated: six Candida albicans , two Candida glabrata , two Candida tropicalis , one Candida parapsilosis and one Candida krusei . Pharmacokinetic parameters were as follows [mean (% coefficient of variation)]: C max (mg/L) = 6.0 (29%); T max (h) = 1.6 (25.8%); C min (mg/L) = 3.2 (36.8%); AUC 0-24 (mg·h/L) = 88.9 (38.6%); t 1/2 (h) = 42.1 (68.2%); CL (L/h) = 1.2 (42.3%); and V (L) = 72.8 (87.8%). A two-compartment model best described the anidulafungin concentrations in the population pharmacokinetic study.
  
  
  
  The pharmacokinetic parameters of anidulafungin in critically ill ICU patients with complicated IAI are similar to those observed in the literature. However, an increased V and a longer t 1/2 were observed in this study. (EudraCT No. 2010-018695-25).
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, CHU Amiens Picardie, Amiens, France.|INSERM UMR 1088, University of Picardy Jules Verne, Amiens, France.
authors.forename: H
authors.initials: H
authors.lastname: Dupont
authors.affiliation: Pharmacology-Toxicology Laboratory, CHU Bichat Claude Bernard, Paris, France.|IAME, UMR 1137, University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Massias
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, CHU Saint-Eloi, Montpellier, France.
authors.forename: B
authors.initials: B
authors.lastname: Jung
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, CHU Amiens Picardie, Amiens, France.
authors.forename: N
authors.initials: N
authors.lastname: Ammenouche
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, CHU Bichat Claude Bernard, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Montravers
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000077612:Anidulafungin; D000935:Antifungal Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D041221:Candida glabrata / Q000187:drug effects / Q000302:isolation & purification; D041022:Candida tropicalis / Q000187:drug effects / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D002851:Chromatography, High Pressure Liquid; D016638:Critical Illness; D054714:Echinocandins / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D059413:Intraabdominal Infections / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D000077612:Anidulafungin