Pharmacokinetic variability and exposures of fluconazole, anidulafungin, and caspofungin in intensive care unit patients: Data from multinational Defining Antibiotic Levels in Intensive care unit (DALI) patients Study.

Abstract:

INTRODUCTION:The objective of the study was to describe the pharmacokinetics (PK) of fluconazole, anidulafungin, and caspofungin in critically ill patients and to compare with previously published data. We also sought to determine whether contemporary fluconazole doses achieved PK/pharmacodynamic (PD; PK/PD) targets in this cohort of intensive care unit patients. METHODS:The Defining Antibiotic Levels in Intensive care unit patients (DALI) study was a prospective, multicenter point-prevalence PK study. Sixty-eight intensive care units across Europe participated. Inclusion criteria were met by critically ill patients administered fluconazole (n = 15), anidulafungin (n = 9), and caspofungin (n = 7). Three blood samples (peak, mid-dose, and trough) were collected for PK/PD analysis. PK analysis was performed by using a noncompartmental approach. RESULTS:The mean age, weight, and Acute Physiology and Chronic Health Evaluation (APACHE) II scores of the included patients were 58 years, 84 kg, and 22, respectively. Fluconazole, caspofungin, and anidulafungin showed large interindividual variability in this study. In patients receiving fluconazole, 33% did not attain the PK/PD target, ratio of free drug area under the concentration-time curve from 0 to 24 hours to minimum inhibitory concentration (fAUC(0-24)/MIC) ≥100. The fluconazole dose, described in milligrams per kilogram, was found to be significantly associated with achievement of fAUC(0-24)/MIC ≥100 (P = 0.0003). CONCLUSIONS:Considerable interindividual variability was observed for fluconazole, anidulafungin, and caspofungin. A large proportion of the patients (33%) receiving fluconazole did not attain the PK/PD target, which might be related to inadequate dosing. For anidulafungin and caspofungin, dose optimization also appears necessary to minimize variability.

journal_name

Crit Care

authors

Sinnollareddy MG,Roberts JA,Lipman J,Akova M,Bassetti M,De Waele JJ,Kaukonen KM,Koulenti D,Martin C,Montravers P,Rello J,Rhodes A,Starr T,Wallis SC,Dimopoulos G,DALI Study authors.

doi

10.1186/s13054-015-0758-3

subject

Has Abstract

pub_date

2015-02-04 00:00:00

pages

33

eissn

1364-8535

issn

1466-609X

pii

10.1186/s13054-015-0758-3

journal_volume

19

pub_type

杂志文章
  • Effects of reduced rebreathing time, in spontaneously breathing patients, on respiratory effort and accuracy in cardiac output measurement when using a partial carbon dioxide rebreathing technique: a prospective observational study.

    abstract:INTRODUCTION:New technology using partial carbon dioxide rebreathing has been developed to measure cardiac output. Because rebreathing increases respiratory effort, we investigated whether a newly developed system with 35 s rebreathing causes a lesser increase in respiratory effort under partial ventilatory support tha...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3801

    authors: Tachibana K,Imanaka H,Takeuchi M,Nishida T,Takauchi Y,Nishimura M

    更新日期:2005-10-05 00:00:00

  • Dynamic hyperinflation and intrinsic positive end-expiratory pressure in ARDS patients.

    abstract:BACKGROUND:In ARDS patients, changes in respiratory mechanical properties and ventilatory settings can cause incomplete lung deflation at end-expiration. Both can promote dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP). The aim of this study was to investigate, in a large population of ARDS...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2611-6

    authors: Coppola S,Caccioppola A,Froio S,Ferrari E,Gotti M,Formenti P,Chiumello D

    更新日期:2019-11-27 00:00:00

  • Serum procalcitonin measurement as diagnostic and prognostic marker in febrile adult patients presenting to the emergency department.

    abstract:INTRODUCTION:Identification of bacterial infections is crucial if treatment is to be initiated early and antibiotics used rationally. The primary objective of this study was to test the efficiency of procalcitonin (PCT) in identifying bacterial/parasitic episodes among febrile adult patients presenting to an emergency ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5926

    authors: Hausfater P,Juillien G,Madonna-Py B,Haroche J,Bernard M,Riou B

    更新日期:2007-01-01 00:00:00

  • The desperate need for good-quality clinical trials to evaluate the optimal source and dose of fibrinogen in managing bleeding.

    abstract::Recent interest in transfusion management of trauma patients has heightened expectation in the role of blood component therapy in improving patient outcome. Optimal transfusion support in supplementation with fibrinogen has not been defined by high-quality evidence. Current evidence comes mainly from case series and u...

    journal_title:Critical care (London, England)

    pub_type: 评论,社论

    doi:10.1186/cc10510

    authors: Stanworth SJ,Hunt BJ

    更新日期:2011-01-01 00:00:00

  • Reliability of standard pupillometry practice in neurocritical care: an observational, double-blinded study.

    abstract:BACKGROUND:In critical care units, pupil examination is an important clinical parameter for patient monitoring. Current practice is to use a penlight to observe the pupillary light reflex. The result seems to be a subjective measurement, with low precision and reproducibility. Several quantitative pupillometer devices ...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章

    doi:10.1186/s13054-016-1239-z

    authors: Couret D,Boumaza D,Grisotto C,Triglia T,Pellegrini L,Ocquidant P,Bruder NJ,Velly LJ

    更新日期:2016-03-13 00:00:00

  • Procalcitonin as a marker of bacterial infection in the emergency department: an observational study.

    abstract:INTRODUCTION:Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. We evaluated the value of PCT as a marker of bacterial infection for emergency department patients. METHODS:This prospective observational study consecutively enrol...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc2396

    authors: Chan YL,Tseng CP,Tsay PK,Chang SS,Chiu TF,Chen JC

    更新日期:2004-02-01 00:00:00

  • Clinical review: Ethics and end-of-life care for critically ill patients in China.

    abstract::Critical care medicine in China has made great advances in recent decades. This has led to an unavoidable issue: end-of-life ethics. With advances in medical technology and therapeutics allowing the seemingly limitless maintenance of life, the exact time of death of an individual patient is often determined by the dec...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc13140

    authors: Li LB

    更新日期:2013-12-04 00:00:00

  • Microcirculatory perfusion disturbances following cardiopulmonary bypass: a systematic review.

    abstract:BACKGROUND:Microcirculatory perfusion disturbances are associated with increased morbidity and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Technological advancements made it possible to monitor sublingual microcirculatory perfusion over time. The goal of this review is to provide...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-02948-w

    authors: den Os MM,van den Brom CE,van Leeuwen ALI,Dekker NAM

    更新日期:2020-05-13 00:00:00

  • Failure to normalize lymphopenia following trauma is associated with increased mortality, independent of the leukocytosis pattern.

    abstract:INTRODUCTION:Following trauma and systemic inflammatory response syndrome (SIRS), the typical response is an elevation of the total complete blood count (CBC) and a reduction of the lymphocyte count. This leukocytosis typically returns to normal within 48 hours. The persistence of a leukocytosis following trauma is ass...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11157

    authors: Heffernan DS,Monaghan SF,Thakkar RK,Machan JT,Cioffi WG,Ayala A

    更新日期:2012-01-20 00:00:00

  • Bending the cost curve in the United States: the role of comparative effectiveness research.

    abstract::Owing to an increasing focus on the rising cost of medical care in the United States, bending the cost curve has become the central tenet of healthcare reform. The exact definition of this phrase, however, remains elusive. In order to affect change in the cost and quality of healthcare, the importance of comparative e...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc9045

    authors: Ghaferi AA

    更新日期:2010-01-01 00:00:00

  • Case mix, outcome and activity for patients with severe acute kidney injury during the first 24 hours after admission to an adult, general critical care unit: application of predictive models from a secondary analysis of the ICNARC Case Mix Programme data

    abstract:INTRODUCTION:This study pools data from the UK Intensive Care National Audit and Research Center (ICNARC) Case Mix Programme (CMP) to evaluate the case mix, outcome and activity for 17,326 patients with severe acute kidney injury (AKI) occurring during the first 24 hours of admission to intensive care units (ICU). MET...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7003

    authors: Kolhe NV,Stevens PE,Crowe AV,Lipkin GW,Harrison DA

    更新日期:2008-01-01 00:00:00

  • Limb ischemia in peripheral veno-arterial extracorporeal membrane oxygenation: a narrative review of incidence, prevention, monitoring, and treatment.

    abstract::Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is an increasingly adopted life-saving mechanical circulatory support for a number of potentially reversible or treatable cardiac diseases. It is also started as a bridge-to-transplantation/ventricular assist device in the case of unrecoverable cardiac or ca...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-019-2541-3

    authors: Bonicolini E,Martucci G,Simons J,Raffa GM,Spina C,Coco VL,Arcadipane A,Pilato M,Lorusso R

    更新日期:2019-07-30 00:00:00

  • Case report: a ball valve blood clot in the airways - life-saving whole tube suction.

    abstract::Respiratory tract obstruction due to a blood clot may result in life threatening ventilatory impairment. Ball valve blood clot obstructions of the airways are rare. A ball valve blood clot acts as a one-way valve, allowing (near) normal air entry into the airways, but (completely) blocking expiration. In a near fatal ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc2903

    authors: Dongelmans DA,Jonkers RE,Schultz MJ

    更新日期:2004-10-01 00:00:00

  • Shock subtypes by left ventricular ejection fraction following out-of-hospital cardiac arrest.

    abstract:BACKGROUND:Post-resuscitation hemodynamic instability following out-of-hospital cardiac arrest (OHCA) may occur from myocardial dysfunction underlying cardiogenic shock and/or inflammation-mediated distributive shock. Distinguishing the predominant shock subtype with widely available clinical metrics may have prognosti...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-018-2078-x

    authors: Anderson RJ,Jinadasa SP,Hsu L,Ghafouri TB,Tyagi S,Joshua J,Mueller A,Talmor D,Sell RE,Beitler JR

    更新日期:2018-06-15 00:00:00

  • Short-term outcomes of cadaveric lung transplantation in ventilator-dependent patients.

    abstract:INTRODUCTION:Survival after cadaveric lung transplantation (LTx) in respiratory failure recipients who were already dependent on ventilation support prior to transplantation is poor, with a relatively high rate of surgical mortality and morbidity. In this study, we sought to describe the short-term outcomes of bilatera...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7989

    authors: Hsu HH,Chen JS,Ko WJ,Huang SC,Kuo SW,Huang PM,Chi NH,Chang CC,Chen RJ,Lee YC

    更新日期:2009-01-01 00:00:00

  • Copeptin levels and commonly used laboratory parameters in hospitalised patients with severe hypernatraemia - the "Co-MED study".

    abstract:BACKGROUND:Hypernatraemia is common in inpatients and is associated with substantial morbidity. Its differential diagnosis is challenging, and delayed treatment may have devastating consequences. The most important hormone for the regulation of water homeostasis is arginine vasopressin, and copeptin, the C-terminal por...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-018-1955-7

    authors: Nigro N,Winzeler B,Suter-Widmer I,Schuetz P,Arici B,Bally M,Refardt J,Betz M,Gashi G,Urwyler SA,Burget L,Blum CA,Bock A,Huber A,Müller B,Christ-Crain M

    更新日期:2018-02-09 00:00:00

  • Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision.

    abstract:INTRODUCTION:Some types of antimicrobial-coated central venous catheters (A-CVC) have been shown to be cost effective in preventing catheter-related bloodstream infection (CR-BSI). However, not all types have been evaluated, and there are concerns over the quality and usefulness of these earlier studies. There is uncer...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7744

    authors: Halton KA,Cook DA,Whitby M,Paterson DL,Graves N

    更新日期:2009-01-01 00:00:00

  • Hypotension and hypovolemia during hemodialysis: is the usual suspect innocent?

    abstract::Hypotension during intermittent hemodialysis is common, and has been attributed to acute volume shifts, shifts in osmolarity, electrolyte imbalance, temperature changes, altered vasoregulation, and sheer hypovolemia. Although hypovolemia may intuitively seem a likely cause for hypotension in intensive care patients, i...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1307-4

    authors: Berger D,Takala J

    更新日期:2016-06-09 00:00:00

  • Early drotrecogin alpha (activated) administration in severe sepsis is associated with lower mortality: a retrospective analysis of the Canadian ENHANCE cohort.

    abstract:INTRODUCTION:Early multimodal treatment of severe sepsis, including the use of drotrecogin alfa (activated) (DrotAA) when indicated, is considered essential for optimum outcome. However, predicting which infected patients will progress to severe sepsis and the need for aggressive intervention continues to be problemati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc7893

    authors: Hodder RV,Hall R,Russell JA,Fisher HN,Lee B

    更新日期:2009-01-01 00:00:00

  • Extracorporeal membrane oxygenation for severe acute respiratory failure.

    abstract::Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support, in case the natural lungs are failing and are not able to maintain a sufficient oxygenation of the body's organ systems. ECMO technique was an adaptation of conventional cardiopulmonary bypass techniques and introduced into treatment...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc689

    authors: Lewandowski K

    更新日期:2000-01-01 00:00:00

  • First evidence of a pro-inflammatory response to severe infection with influenza virus H1N1.

    abstract::The great majority of infections caused by the pandemic variant of the influenza virus (nvH1N1) are self-limited, but a small percentage of patients develop severe symptoms requiring hospitalization. Bermejo-Martin and colleagues have presented a pilot study describing the differences in the early immune response for ...

    journal_title:Critical care (London, England)

    pub_type: 评论,信件

    doi:10.1186/cc8846

    authors: de Castro IF,Guzmán-Fulgencio M,García-Alvarez M,Resino S

    更新日期:2010-01-01 00:00:00

  • Predicting on-going hemorrhage and transfusion requirement after severe trauma: a validation of six scoring systems and algorithms on the TraumaRegister DGU.

    abstract:INTRODUCTION:The early aggressive management of the acute coagulopathy of trauma may improve survival in the trauma population. However, the timely identification of lethal exsanguination remains challenging. This study validated six scoring systems and algorithms to stratify patients for the risk of massive transfusio...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11432

    authors: Brockamp T,Nienaber U,Mutschler M,Wafaisade A,Peiniger S,Lefering R,Bouillon B,Maegele M,TraumaRegister DGU.

    更新日期:2012-07-20 00:00:00

  • Vasopressin in vasodilatory shock: hemodynamic stabilization at the cost of the liver and the kidney?

    abstract::Infusing arginine vasopressin (AVP) in advanced vasodilatory shock is usually accompanied by a decrease in cardiac index and systemic oxygen transport. Whether or not such a vasoconstriction impedes regional blood flow and thus visceral organ function, even when low AVP is used, is still a matter of debate. Krejci and...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章,评审

    doi:10.1186/cc6171

    authors: Bracht H,Asfar P,Radermacher P,Calzia E

    更新日期:2007-01-01 00:00:00

  • The effect of open lung ventilation on right ventricular and left ventricular function in lung-lavaged pigs.

    abstract:INTRODUCTION:Ventilation according to the open lung concept (OLC) consists of recruitment maneuvers, followed by low tidal volume and high positive end-expiratory pressure, aiming at minimizing atelectasis. The minimization of atelectasis reduces the right ventricular (RV) afterload, but the increased intrathoracic pre...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc4944

    authors: Miranda DR,Klompe L,Cademartiri F,Haitsma JJ,Palumbo A,Takkenberg JJ,Lachmann B,Bogers AJ,Gommers D

    更新日期:2006-01-01 00:00:00

  • Cerebral microdialysis for detection of bacterial meningitis in aneurysmal subarachnoid hemorrhage patients: a cohort study.

    abstract:INTRODUCTION:Bacterial meningitis (BM) is a severe complication in patients with aneurysmal subarachnoid haemorrhage (SAH). Clinical signs of meningitis are often masked by SAH-related symptoms, and routine cerebrospinal fluid (CSF) analysis fails to indicate BM. Microdialysis (MD) is a technique for monitoring cerebra...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7689

    authors: Schlenk F,Frieler K,Nagel A,Vajkoczy P,Sarrafzadeh AS

    更新日期:2009-01-01 00:00:00

  • Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients.

    abstract:INTRODUCTION:Ultrasound of the lung and quantification of B lines was recently introduced as a novel tool to detect overhydration. In the present study, we aimed to evaluate a four-region protocol of lung ultrasound to determine the pulmonary fluid status in ventilated patients in the intensive care unit. METHODS:Fift...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0756-5

    authors: Enghard P,Rademacher S,Nee J,Hasper D,Engert U,Jörres A,Kruse JM

    更新日期:2015-02-06 00:00:00

  • In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable.

    abstract:BACKGROUND:Esophageal pressure (Pes) can provide information to guide mechanical ventilation in acute respiratory failure. However, both relative changes and absolute values of Pes can be affected by inappropriate filling of the esophageal balloon and by the elastance of the esophagus wall. We evaluated the feasibility...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1278-5

    authors: Mojoli F,Iotti GA,Torriglia F,Pozzi M,Volta CA,Bianzina S,Braschi A,Brochard L

    更新日期:2016-04-11 00:00:00

  • A 10-second fluid challenge guided by transthoracic echocardiography can predict fluid responsiveness.

    abstract:INTRODUCTION:The accurate assessment of intravascular volume status for the therapy of severe hypovolemia and shock is difficult and critical to critically ill patients. Non-invasive evaluation of fluid responsiveness by the rapid infusion of a very limited amount of volume is an important clinical goal. This study aim...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13891

    authors: Wu Y,Zhou S,Zhou Z,Liu B

    更新日期:2014-05-27 00:00:00

  • Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial.

    abstract:INTRODUCTION:Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. Concerns relate to the side effects of succinylcholine and to slower onset and inferior intubation conditions associated with rocuronium. So far, succinylcholine and rocuronium have not...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc10367

    authors: Marsch SC,Steiner L,Bucher E,Pargger H,Schumann M,Aebi T,Hunziker PR,Siegemund M

    更新日期:2011-08-16 00:00:00

  • During critical illness the gut does not pass the acid test.

    abstract::The composition and function of intestinal microflora are emerging as integral to both health and disease. During critical illness the normal microbiota are rapidly replaced by pathogenic species as a result of both the physiologic stress itself and the use of antibiotics. In this report, the authors use fecal pH as a...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11474

    authors: Alverdy JC

    更新日期:2012-09-12 00:00:00