Anidulafungin pharmacokinetics in critically ill patients

Van Wanrooy, M. J. P., Rodgers, M. G. G., Uges, D. R. A., Arends, J. P., Zijlstra, J. G., Van Der Werf, T. S., Kosterink, J. G. W. & Alffenaar, J. W. C., 1-Apr-2012, p. 445-446. 2 p.

Research output: Contribution to conferencePosterAcademic

Objectives: Early antifungal treatment with adequate drug exposure reduces mortality in patients with candidemia. Efficacy of anidulafungin is driven by AUC (area under the curve)/MIC ratio. As anidulafungin clearance is ∼30% higher in patients with invasive candidiasis than in patients with oesophageal candidiasis patients at the ICU may be at risk for underexposure. Therefore, insight in anidulafungin pharmacokinetics in a “real-life” population of critically ill patients is important. Methods: We conducted a prospective open-label study in adult patients admitted to an intensive care unit between June 2010 and November 2011. Patients were eligible for inclusion in case of a positive culture for Candida from a sterile site - blood or intraabdominal fluid. Blood samples were taken just before administering anidulafungin and at 1.5, 2, 3, 4, 6, 8, 12 and 24 hours after start of infusion on day 3 or 4 of treatment. Anidulafungin plasma concentrations were measured with a validated LC-MS/MS method. The AUC was calculated using a non compartmental method. Results: Twenty patients with a median age of 71 (IQR: 60-75) were studied; 11 males and 9 females. Cultures for Candida were positive in blood for seven patients and in intra-abdominal fluid for 13 patients. In comparison with previously reported data of critically ill patients, we observed an apparent lower exposure and clearance and longer half-life in our patients, see Table. The volume of distribution was similar. MIC values ranged from
Original languageEnglish
Number of pages2
Publication statusPublished - 1-Apr-2012


  • anidulafungin, antifungal agent, pharmacokinetics, critically ill patient, human, microbiology, infection, patient, area under the curve, exposure, Candida, blood, maximum plasma concentration, liquid, candidemia, adult, population, risk, esophagus candidiasis, minimum inhibitory concentration, female, open study, intensive care unit, half life time, mortality, invasive candidiasis, blood level, infusion, blood sampling, male, correlation coefficient, prospective study, drug exposure

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