Suboptimal exposure to fluconazole in critically ill patients: Pharmacokinetic analysis and determinants.
Infect Dis Now
; 53(2): 104630, 2023 Mar.
Article
en En
| MEDLINE
| ID: mdl-36328312
ABSTRACT
OBJECTIVES:
This study aims at evaluating fluconazole exposure in critically ill patients and identifying variables associated with the latter. PATIENTS ANDMETHODS:
This was a 2-year (2018-2019) retrospective multicenter cohort study. Adult patients > 18 years-old with at least one fluconazole concentration measurement during their ICU stay were included.RESULTS:
Twenty patients were included. Only 11 patients had a fluconazole trough concentration (Cmin) within the target range (≥15 mg/L). According to bivariable analysis, SOFA score, GGT, fluconazole clearance, Ke, and Vd, were independently associated with a decrease in fluconazole Cmin. The median loading dose required to achieve the Cmin target appeared to be greater in patients with higher SOFA or GGT level and in patients undergoing renal replacement therapy.CONCLUSIONS:
This study supports recommendation for routine fluconazole therapeutic drug monitoring in ICU patients so as to avoid underexposure, especially if SOFA score is ≥ 7 and/or GGT is ≥ 100 U/L.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fluconazol
/
Antifúngicos
Tipo de estudio:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Humans
Idioma:
En
Revista:
Infect Dis Now
Año:
2023
Tipo del documento:
Article