ReviewAntibiotics (Basel, Switzerland)2022
Therapeutic Drug Monitoring of Antifungal Agents in Critically Ill Patients: Is There a Need for Dose Optimisation?
Review in Antibiotics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Guideline
- Research trends and emerging topics in antifungal therapeutic drug monitoring: a bibliometric analysis with implications for clinical pharmacy practice.International journal of clinical pharmacy · 2026Review
- COVID-19-Associated Fungal Co-Infections: Pathogenesis, Diagnostics, Biomarkers, and Therapeutic Strategies.Journal of clinical medicine · 2026Review
- Therapeutic Failure in Invasive Fungal Infections: Beyond Antifungal Resistance-A Narrative Review.Journal of fungi (Basel, Switzerland) · 2026Review
- Invasive Candidiasis in Critically Ill Patients: Fundamental Concepts and Future Directions.Chest · 2026Review
- IFUCISTRATEGY: A Spanish Survey on the Management of Invasive Fungal Infection (IFI) in Critically Ill Patients.Journal of fungi (Basel, Switzerland) · 2026Article
- Article
- Nanosystems for delivery of indolicidin peptide.Frontiers in medical technology · 2026Review
- Antifungal treatment strategies and their impact on resistance development in clinical settings.The Journal of antimicrobial chemotherapy · 2025Review
- Antifungal resistance: Emerging mechanisms and implications (Review).Molecular medicine reports · 2025Review
- DeepTDM: Deep Learning-Based Prediction of Sequential Therapeutic Drug Monitoring Levels of Vancomycin.IEEE journal of translational engineering in health and medicine · 2025Article
- Oral flucytosine dosing in peritoneal dialysis.Antimicrobial agents and chemotherapy · 2024Article
- Ligand- and Structure-Based Virtual Screening Identifies New Inhibitors of the Interaction of the SARS-CoV-2 Spike Protein with the ACE2 Host Receptor.Pharmaceutics · 2024Article
- UPLC-MS/MS method for fluconazole determination in plasma and its application in Mexican patients with candidaemia.Bioanalysis · 2024Article
- Diagnosis and management of invasive fungal diseases in non-neutropenic ICU patients, with focus on candidiasis and aspergillosis: a comprehensive review.Frontiers in cellular and infection microbiology · 2024Review
- Pharmacokinetic and pharmacodynamic considerations for antifungal therapy optimisation in the treatment of intra-abdominal candidiasis.Critical care (London, England) · 2023Review
- Critical appraisal beyond clinical guidelines for intraabdominal candidiasis.Critical care (London, England) · 2023Review
- Antifungal Dosing in Critically Ill Patients on Extracorporeal Membrane Oxygenation.Clinical pharmacokinetics · 2023Review
- Therapeutic Drug Monitoring of Antimicrobials in Critically Ill Obese Patients.Antibiotics (Basel, Switzerland) · 2023Article
- Editorial for the Special Issue: "Therapeutic Drug Monitoring of Antimicrobials".Antibiotics (Basel, Switzerland) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Invasive fungal infections are an important cause of morbidity and mortality, especially in critically ill patients. Increasing resistance rates and inadequate antifungal exposure have been documented in these patients, due to clinically relevant pharmacokinetic (PK) and pharmacodynamic (PD) alterations, leading to treatment failure. Physiological changes such as third spacing (movement of fluid from the intravascular compartment to the interstitial space), hypoalbuminemia, renal failure and hepatic failure, as well as common interventions in the intensive care unit, such as renal replacement therapy and extracorporeal membrane oxygenation, can lead to these PK and PD alterations. Consequently, a therapeutic target concentration that may be useful for one patient may not be appropriate for another. Regular doses do not take into account the important PK variations in the critically ill, and the need to select an effective dose while minimising toxicity advocates for the use of therapeutic drug monitoring (TDM). This review aims to describe the current evidence regarding optimal PK/PD indices associated with the clinical efficacy of the most commonly used antifungal agents in critically ill patients (azoles, echinocandins, lipid complexes of amphotericin B, and flucytosine), provide a comprehensive understanding of the factors affecting the PK of each agent, document the PK parameters of critically ill patients compared to healthy volunteers, and, finally, make recommendations for therapeutic drug monitoring (TDM) of antifungals in critically ill patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.