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Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis

WHAT IS KNOWN AND OBJECTIVE: Anidulafungin, caspofungin and micafungin are three widely used echinocandin drugs licensed for the treatment of invasive fungal infections, and their clinical use is widespread. To evaluate pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill...

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Autores principales: Liu, Xiaoqing, Liu, Dongdong, Pan, Ying, Li, Yimin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689702/
https://www.ncbi.nlm.nih.gov/pubmed/32672361
http://dx.doi.org/10.1111/jcpt.13211
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author Liu, Xiaoqing
Liu, Dongdong
Pan, Ying
Li, Yimin
author_facet Liu, Xiaoqing
Liu, Dongdong
Pan, Ying
Li, Yimin
author_sort Liu, Xiaoqing
collection PubMed
description WHAT IS KNOWN AND OBJECTIVE: Anidulafungin, caspofungin and micafungin are three widely used echinocandin drugs licensed for the treatment of invasive fungal infections, and their clinical use is widespread. To evaluate pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients by comparing the differences in pharmacokinetic parameters between critically ill patients and healthy volunteers or general patients. METHODS: MEDLINE, EMBASE, The Cochrane Library and Pubmed were searched from inception until 6 September 2018. Studies investigating the pharmacokinetic parameters of echinocandins in critically ill patients, healthy volunteers or general patients were included. Our primary outcomes included AUC(0‐24 h), C(max) and C(min) (24 hours). Two reviewers independently reviewed all titles, abstracts and text, and extracted data. We applied R software (R 2017) to conduct meta‐analysis. RESULTS AND DISCUSSION: Of 3235 articles screened, 17 studies were included in the data synthesis. Descriptive data from single‐arm studies show that critically ill patients who received caspofungin had more stable AUC(0‐24 h) than those who received anidulafungin and micafungin. The C(max) of critically ill patients who received caspofungin and micafungin was similar to healthy volunteers. However, the C(max) in critically ill patients who received anidulafungin was lower than in healthy volunteers. The C(min) and T(1/2) of critically ill patients who received caspofungin were larger than in healthy volunteers. The V(d) and CL of critically ill patients receiving anidulafungin and micafungin were larger than in healthy volunteers. WHAT IS NEW AND CONCLUSION: This systematic review provides an analysis of the pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients. Based on the limited data available, caspofungin has less pharmacokinetic/pharmacodynamics variability than anidulafungin and micafungin.
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spelling pubmed-76897022020-12-05 Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis Liu, Xiaoqing Liu, Dongdong Pan, Ying Li, Yimin J Clin Pharm Ther Review Articles WHAT IS KNOWN AND OBJECTIVE: Anidulafungin, caspofungin and micafungin are three widely used echinocandin drugs licensed for the treatment of invasive fungal infections, and their clinical use is widespread. To evaluate pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients by comparing the differences in pharmacokinetic parameters between critically ill patients and healthy volunteers or general patients. METHODS: MEDLINE, EMBASE, The Cochrane Library and Pubmed were searched from inception until 6 September 2018. Studies investigating the pharmacokinetic parameters of echinocandins in critically ill patients, healthy volunteers or general patients were included. Our primary outcomes included AUC(0‐24 h), C(max) and C(min) (24 hours). Two reviewers independently reviewed all titles, abstracts and text, and extracted data. We applied R software (R 2017) to conduct meta‐analysis. RESULTS AND DISCUSSION: Of 3235 articles screened, 17 studies were included in the data synthesis. Descriptive data from single‐arm studies show that critically ill patients who received caspofungin had more stable AUC(0‐24 h) than those who received anidulafungin and micafungin. The C(max) of critically ill patients who received caspofungin and micafungin was similar to healthy volunteers. However, the C(max) in critically ill patients who received anidulafungin was lower than in healthy volunteers. The C(min) and T(1/2) of critically ill patients who received caspofungin were larger than in healthy volunteers. The V(d) and CL of critically ill patients receiving anidulafungin and micafungin were larger than in healthy volunteers. WHAT IS NEW AND CONCLUSION: This systematic review provides an analysis of the pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients. Based on the limited data available, caspofungin has less pharmacokinetic/pharmacodynamics variability than anidulafungin and micafungin. John Wiley and Sons Inc. 2020-07-16 2020-12 /pmc/articles/PMC7689702/ /pubmed/32672361 http://dx.doi.org/10.1111/jcpt.13211 Text en © 2020 The Authors. Journal of Clinical Pharmacy and Therapeutics published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Review Articles
Liu, Xiaoqing
Liu, Dongdong
Pan, Ying
Li, Yimin
Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis
title Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis
title_full Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis
title_fullStr Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis
title_full_unstemmed Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis
title_short Pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: A systematic review and meta‐analysis
title_sort pharmacokinetic/pharmacodynamics variability of echinocandins in critically ill patients: a systematic review and meta‐analysis
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689702/
https://www.ncbi.nlm.nih.gov/pubmed/32672361
http://dx.doi.org/10.1111/jcpt.13211
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