Assessment of micafungin loading dosage regimens against Candida spp. in ICU patients by Monte Carlo simulations

doi:10.1007/s00228-020-02840-0

	Assessment of micafungin loading dosage regimens against Candida spp. in ICU patients by Monte Carlo simulations
	Lu, Xiaoqing 1; Xu, Gaoqi 2,3,4; Chen, Lu 1; Fan, Jingjing 5; Li, Mengxue 1; Zhu, Liqin 1,6
刊名	EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
	2020-02-11
关键词	Micafungin Loading dose Candida spp ICU patients
ISSN号	0031-6970
DOI	10.1007/s00228-020-02840-0
通讯作者	Zhu, Liqin(zlq0713@aliyun.com)
英文摘要	Objective To assess the efficacy of loading dose on micafungin by simulating different dosage regimens. Methods A published study of micafungin in ICU patients was employed to simulate nine different dosage regimens which were sorted out three groups in terms of three maintenance doses. Using pharmacokinetic parameters and pharmacodynamic data, 5000-subject Monte Carlo simulations were conducted to simulate concentration-time profiles of micafungin, calculate probabilities of target attainment (PTAs), and cumulative fractions of response (CFRs) in terms of AUC/MIC targets. PTAs were calculated using AUC/MIC cut-offs: 285 (Candida parapsilosis), 3000 (all Candida spp.), and 5000 (non-parapsilosis Candida spp.). PTA or CFR > 90% was considered optimal for a dosage regimen. Results The concentration-time profiles of micafungin-simulated dosage regimens were obtained. PTA values were over 90% while applying the loading dose in each group of regimens: for Candida albicans and Candida glabrata (AUC/MIC = 5000), all regimens with loading dose provided PTAs of >= 90% for MIC <= 0.008 mg/L. The PTAs (AUC/MIC = 3000) were over 90% for MIC <= 0.008 mg/L in any regimen. However, for MIC inferior to 0.016 mg/L, only loading dosage regimens provided PTAs exceeding 90%. For C. parapsilosis (AUC/MIC = 285), the maximum MIC of achieving a PTA >= 90% was 0.25 mg/L both in the regimens of B (150 mg maintenance dose) and C (200 mg maintenance dose) with loading dose. In addition, CFR of any regimen with loading dose was >= 90% against C. albicans and C. glabrata. None of the dosage regimens achieved an expected CFR against C. parapsilosis. Conclusions The dosage regimen of micafungin which had a loading dose of 1.5 times was more suitable for ICU patients infected by Candida spp.
WOS关键词	INFECTIOUS-DISEASES SOCIETY ; CRITICALLY-ILL PATIENTS ; INVASIVE CANDIDIASIS ; PHARMACOKINETICS ; ECHINOCANDIN ; CASPOFUNGIN ; EFFICACY ; PHARMACODYNAMICS ; ANIDULAFUNGIN ; VORICONAZOLE
WOS研究方向	Pharmacology & Pharmacy
语种	英语
出版者	SPRINGER HEIDELBERG
WOS记录号	WOS:000517463700001
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/103967]
专题	中国科学院合肥物质科学研究院
通讯作者	Zhu, Liqin
作者单位	1.Tianjin Med Univ, Pharmaceut Coll, Tianjin, Peoples R China 2.Chinese Acad Sci, ICBM, Hangzhou, Zhejiang, Peoples R China 3.Univ Chinese Acad Sci, Canc Hosp, Dept Pharm, Hangzhou, Zhejiang, Peoples R China 4.Zhejiang Canc Hosp, Dept Pharm, Hangzhou, Zhejiang, Peoples R China 5.Tianjin Univ Tradit Chinese Med, Grad Sch, Tianjin, Peoples R China 6.Tianjin First Cent Hosp, Dept Pharm, 24 Fukang Rd, Tianjin 300192, Peoples R China
推荐引用方式 GB/T 7714	Lu, Xiaoqing,Xu, Gaoqi,Chen, Lu,et al. Assessment of micafungin loading dosage regimens against Candida spp. in ICU patients by Monte Carlo simulations[J]. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY,2020.
APA	Lu, Xiaoqing,Xu, Gaoqi,Chen, Lu,Fan, Jingjing,Li, Mengxue,&Zhu, Liqin.(2020).Assessment of micafungin loading dosage regimens against Candida spp. in ICU patients by Monte Carlo simulations.EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY.
MLA	Lu, Xiaoqing,et al."Assessment of micafungin loading dosage regimens against Candida spp. in ICU patients by Monte Carlo simulations".EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY (2020).