2026-04-30T10:28:18Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/110822025-04-24T17:05:34Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19609
Repisalud
author
Gioia, Francesca
author
Gomez-Lopez, Alicia
author
Alvarez, Maria Elena
author
Gómez-García de la Pedrosa, Elia
author
Martín-Dávila, Pilar
author
Cuenca-Estrella, Manuel
author
Moreno, Santiago
author
Fortún, Jesús
funder
Instituto de Salud Carlos III
funder
Ministerio de Ciencia, Innovación y Universidades (España)
funder
RETICS-Investigación en Patología Infecciosa (REIPI-ISCIII) (España)
funder
Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
2020-09-29T09:14:10Z
2020-09-29T09:14:10Z
2020-09-13
Int J Infect Dis. 2020 Dec;101:24-28.
10.1016/j.ijid.2020.09.019
1878-3511
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
32937195
http://hdl.handle.net/20.500.12105/11082
Introduction: A possible increase in Candida resistance, especially in Candida glabrata, has been speculated according to poor diffusion of echinocandins to peritoneal fluid. Materials/methods: Peritoneal and serum concentrations of caspofungin, micafungin and anidulafungin were analysed in surgical patients with suspected candida peritonitis. After 4 days of starting therapy, serum and peritoneal samples (through peritoneal drainage) were obtained at baseline, 1, 6, 12 and 24 h of drug administration. Micafungin and anidulafungin concentrations were determined using highperformance liquid chromatography (HPLC/F), whereas caspofungin concentrations were established by bioassay. Results: Twenty-three critically ill patients with suspected abdominal fungal infection who were receiving an echinocandin were prospectively recruited. No specific criteria were applied to prescribe one specific echinocandin. No special clinical differences were observed among the three groups of patients. All were receiving antibiotic therapy, 80% required inotropic drugs, and fungal peritonitis was confirmed in 74% of them. The AUC0_24h (mg h/L) obtained in serum and peritoneal fluid were: 126.84 and 34.38, 98.52 and 18.83, and 66.9 and 8.78 for anidulafungin, micafungin and caspofungin, respectively. The median concentration in peritoneal fluid ranged from 0.66 to 1.82mg/mL for anidulafungin, 0.68–0.88mg/mL for micafungin and 0.21–0.46 mg/mL for caspofungin. Conclusion: The results showed moderate penetration of echinocandins into the peritoneal fluid of these patients. These levels are below the threshold of resistance mutant selection published by other authors. This could justify a potential risk of resistance in patients with prolonged treatment with echinocandins and suboptimal control of abdominal infection.
eng
Echinocandins
Pharmacokinetics
Candida
Peritonitis
Resistance
Pharmacokinetics of Echinocandins in Suspected Candida Peritonitis: a Potential Risk for Resistance
research article
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PharmacokineticsEchinocandinsSuspectedCandidaPeritonitis_2020.pdf
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PharmacokineticsEchinocandinsSuspectedCandidaPeritonitis_2020.pdf.txt