Infectious diseases and therapy · 2025
Impact of Continuous Renal Replacement Therapy with Polyacrylonitrile-Derived Filter on Caspofungin Concentration: A Retrospective Study.
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Arrestier Romain, Pressiat Claire, Bouabdallah Laura, Masi Paul, Mongardon Nicolas, Hulin Anne, Mekontso Dessap Armand, Razazi Keyvan
Аннотация
INTRODUCTION: Caspofungin pharmacokinetics may be altered in critically ill patients. In vitro studies suggest significant drug adsorption with polyacrylonitrile (PAN) membranes during continuous renal replacement therapy (CRRT).
METHODS: This study retrospectively analyzed 66 plasma caspofungin concentrations (pCASconc) from 35 ICU patients between 2021 and 2024, comparing those on PAN-CRRT (n = 19) versus those without (n = 47).
RESULTS: Caspofungin is mainly prescribed for candidemia (40%) and invasive Candida infections (25.7%). Median pCASconc at 12 h was similar between groups, but at 18 and 24 h, it was significantly higher in the PAN-CRRT group [5.3 (4.1-6.9) vs. 3.3 (1.9-3.7) mg/L, p = 0.04 and 5.3 (3.9-5.8) vs. 3.1 (2.5-4.5) mg/L, p = 0.01, respectively]. ECMO use was more frequent in PAN-CRRT patients (75% vs. 21.7%, p = 0.01). Persistent candidemia occurred in three patients (one in PAN-CRRT, two in non-PAN-CRRT).
CONCLUSION: This study found no evidence of caspofungin depletion with PAN-CRRT, warranting further research on clinical outcomes.
METHODS: This study retrospectively analyzed 66 plasma caspofungin concentrations (pCASconc) from 35 ICU patients between 2021 and 2024, comparing those on PAN-CRRT (n = 19) versus those without (n = 47).
RESULTS: Caspofungin is mainly prescribed for candidemia (40%) and invasive Candida infections (25.7%). Median pCASconc at 12 h was similar between groups, but at 18 and 24 h, it was significantly higher in the PAN-CRRT group [5.3 (4.1-6.9) vs. 3.3 (1.9-3.7) mg/L, p = 0.04 and 5.3 (3.9-5.8) vs. 3.1 (2.5-4.5) mg/L, p = 0.01, respectively]. ECMO use was more frequent in PAN-CRRT patients (75% vs. 21.7%, p = 0.01). Persistent candidemia occurred in three patients (one in PAN-CRRT, two in non-PAN-CRRT).
CONCLUSION: This study found no evidence of caspofungin depletion with PAN-CRRT, warranting further research on clinical outcomes.