Overview of antifungal dosing in invasive candidiasis

Overview of antifungal dosing in invasive candidiasis
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DOI:
10.1093/jac/dkx447
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发表时间:
2018-01-01
影响因子:
5.2
通讯作者:
Lewis, Russell E.
Lewis, Russell E.
中科院分区:
医学2区
文献类型:
--
作者:
Pea, Federico;Lewis, Russell E.

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In the past, most antifungal therapy dosing recommendations for invasive candidiasis followed a 'one-size fits all' approach with recommendations for lowering maintenance dosages for some antifungals in the setting of renal or hepatic impairment. A growing body of pharmacokinetic/pharmacodynamic research, however now points to a widespread 'silent epidemic' of antifungal underdosing for invasive candidiasis, especially among critically ill patients or special populations who have altered volume of distribution, protein binding and drug clearance. In this review, we explore how current adult dosing recommendations for antifungal therapy in invasive candidiasis have evolved, and special populations where new approaches to dose optimization or therapeutic drug monitoring may be needed, especially in light of increasing antifungal resistance among Candida spp.