Using pharmacokinetics and pharmacodynamics to optimise dosing of antifungal agents in critically ill patients: A systematic review

Sinnollareddy, Mahipal, Peake, Sandra L., Roberts, Michael S., Lipman, Jeffrey and Roberts, Jason A. (2012) Using pharmacokinetics and pharmacodynamics to optimise dosing of antifungal agents in critically ill patients: A systematic review. International Journal of Antimicrobial Agents, 39 1: 1-10. doi:10.1016/j.ijantimicag.2011.07.013

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Author Sinnollareddy, Mahipal
Peake, Sandra L.
Roberts, Michael S.
Lipman, Jeffrey
Roberts, Jason A.
Title Using pharmacokinetics and pharmacodynamics to optimise dosing of antifungal agents in critically ill patients: A systematic review
Journal name International Journal of Antimicrobial Agents   Check publisher's open access policy
ISSN 0924-8579
1872-7913
Publication date 2012-01
Year available 2011
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.ijantimicag.2011.07.013
Volume 39
Issue 1
Start page 1
End page 10
Total pages 10
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2012
Language eng
Formatted abstract
The prevalence of invasive fungal infections (IFIs) caused by Candida spp. is increasing in critically ill patients. Recent development of new antifungal agents has significantly contributed to the successful treatment of IFIs. However, the pharmacokinetics of antifungal agents can be altered in a number of disease states, including critical illness. Therefore, doses established in healthy volunteers and other patient groups may not be appropriate for the critically ill. Moreover, inadequate dosing may contribute to treatment failure and the emergence of resistance. This systematic review provides a critical analysis of the pharmacokinetics of antifungal agents in the critically ill and their relevance to dosing requirements in clinical practice. Based on the limited data available, dosing of some antifungal agents may have to be adjusted in critically ill patients with conserved renal function as well as in those requiring renal replacement therapy. Further research to confirm the appropriateness of current dosing strategies to attain the appropriate pharmacodynamic targets is recommended.
Keyword Pharmacokinetics
Pharmacodynamics
Antifungal agents
Critically ill
Renal replacement therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 16 September 2011.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Thu, 22 Dec 2011, 15:34:58 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH