ArticleCritical care (London, England)2015
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.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 4 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Guideline
- Pooled it
- Choosing the Right Antifungal Agent in ICU Patients.Advances in therapy · 2019Pooled it
- Intensive care medicine research agenda on invasive fungal infection in critically ill patients.Intensive care medicine · 2017Pooled it
- Pharmacokinetics of Anidulafungin in Critically Ill Intensive Care Unit Patients with Suspected or Proven Invasive Fungal Infections.Antimicrobial agents and chemotherapy · 2017Trial
- Low Caspofungin Exposure in Patients in Intensive Care Units.Antimicrobial agents and chemotherapy · 2017Trial
- Comparative Population Plasma and Tissue Pharmacokinetics of Micafungin in Critically Ill Patients with Severe Burn Injuries and Patients with Complicated Intra-Abdominal Infection.Antimicrobial agents and chemotherapy · 2016Trial
- Can Fluconazole Be Used to Treat Non-Resistant Candida (Candidozyma) auris Infections? Preclinical Pharmacokinetic/Pharmacodynamic Data From a Galleria mellonella Infection Model.The Journal of infectious diseases · 2026Article
- Population Pharmacokinetic Modeling of Intravenous Fluconazole to Inform eGFR-Based Dosing: A Simulation Study Demonstrating Superiority over Standard Regimens.Pharmaceutics · 2026Article
- Population pharmacokinetics of caspofungin in critically ill Chinese children: a prospective observational study.Antimicrobial agents and chemotherapy · 2026Observational
- Condensation of fluconazole and zinc undecylanate particles using low-pressure RF plasma: a novel drug combination approach.BMC pharmacology & toxicology · 2025Article
- Diagnosis and management of invasive candidiasis in critically ill patients: SIAARTI multidisciplinary statement.Journal of anesthesia, analgesia and critical care · 2025Review
- Review on the management of intra-abdominal candidiasis.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Low-level direct currents eradicate multi-drug-resistantChemical engineering journal (Lausanne, Switzerland : 1996) · 2025Article
- Impact of Continuous Renal Replacement Therapy with Polyacrylonitrile-Derived Filter on Caspofungin Concentration: A Retrospective Study.Infectious diseases and therapy · 2025Article
- Therapeutic role of fluconazole in immunocompetent patients with pulmonary cryptococcosis: A case report.IDCases · 2025Article
- Editorial: Progressing the understanding and management of bloodstream infections.Frontiers in medicine · 2025Article
- Predictors of caspofungin exposure-response relationship: a retrospective cohort study on therapeutic drug monitoring parameters.Frontiers in pharmacology · 2025Article
- Parametric and nonparametric population pharmacokinetic analysis of fluconazole in critically ill patients and dosing simulations forAntimicrobial agents and chemotherapy · 2024Article
- ISCCM Position Statement on the Management of Invasive Fungal Infections in the Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
2 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors at 11 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe 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.
methodsThe 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.
resultsThe 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).
conclusionsConsiderable 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.
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