Optimal prophylactic dosage and disposition of micafungin in living donor liver recipients
Optimal prophylactic dosage and disposition of micafungin in living donor liver recipients
复制标题
DOI：
10.1111/j.1399-0012.2004.00272.x
复制
发表时间：
2004-12-01
影响因子：
2.1
通讯作者：
Todo, S
中科院分区：
文献类型：
--
作者：
Kishino, S;Ohno, K;Todo, S
米卡芬净是一种新型念珠菌抗真菌药物，具有良好的安全性，对念珠菌和曲霉菌具有显着的治疗效果。然而，关于肝移植受者中米卡芬净的最佳预防剂量和处置，或连续静脉血液透析 (CVVH) 对米卡芬净药代动力学的影响，人们知之甚少。六名活体肝移植患者参与了这项研究。血浆中米卡芬净的平均 C-max 和 C-min（谷）值分别为 6.31 +/- 1.08 和 1.65 +/- 0.54 mug/mL。平均消除半衰期（t（1/2））和给药后12小时（AUC 0-12小时）的平均曲线下面积分别为13.63 +/- 2.77 h和50.04 +/- 6.48 mug.h/mL。透析器入口和出口处的米卡芬净浓度非常相似。透析器入口和出口米卡芬净浓度的平均 (+/-SD) 比率 (coutlet/cinlet) 和米卡芬净清除率分别为 0.96 +/- 0.04 和 0.054 +/- 0.04 mL/min/kg。超滤液中的量为1.0mg。米卡芬净可有效预防肝移植患者的全身真菌感染。米卡芬净在受者体内的分布没有观察到显着差异，米卡芬净剂量为40-50 mg/d即可达到治疗药物水平。 CVVH 对米卡芬净动力学影响很小，CVVH 期间无需调整剂量或修改给药间隔。
Micafungin, a new candin antifungal drug, has a good safety profile and a significant therapeutic effect against Candida and Aspergillus. Little is known, however, about the optimal prophylactic dosage and the disposition of micafungin in liver transplant recipients, or about the effect of continuous venovenous hemodialysis (CVVH) on the pharmacokinetics of micafungin. Six living donor liver transplant patients were enrolled in this study. The mean C-max and C-min (trough) values of micafungin in plasma were 6.31 +/- 1.08 and 1.65 +/- 0.54 mug/mL, respectively. The mean elimination half-life (t(1/2)) and mean area under the curve up to 12 h post-dosing (AUC 0-12 h) were 13.63 +/- 2.77 h and 50.04 +/- 6.48 mug.h/mL, respectively. The concentrations of micafungin at the inlet and outlet of the dialyzer were very similar. The mean (+/-SD) ratio of micafungin concentrations at the inlet and outlet of the dialyzer (coutlet/cinlet) and the clearance of micafungin were 0.96 +/- 0.04 and 0.054 +/- 0.04 mL/min/kg, respectively. The amount in the ultrafiltrate was 1.0 mg. Micafungin effectively prevents systemic fungal infection in patients who have undergone liver transplantation. No significant differences were observed in the disposition of micafungin in recipients, and the therapeutic drug level can be achieved by administration of micafungin at a dosage of 40-50 mg/d. The CVVH had little effect on micafungin kinetics, and no dose adjustment or modification of dosing interval was needed during CVVH.