Impact of Continuous Renal Replacement Therapy with Polyacrylonitrile-Derived Filter on Caspofungin Concentration: A Retrospective Study.

IF 5.3 3区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases and Therapy Pub Date : 2025-08-01 Epub Date: 2025-07-05 DOI:10.1007/s40121-025-01191-6

Romain Arrestier, Claire Pressiat, Laura Bouabdallah, Paul Masi, Nicolas Mongardon, Anne Hulin, Armand Mekontso Dessap, Keyvan Razazi

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引用次数: 0

Abstract

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 (pCAS_conc) 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 pCAS_conc 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.

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聚丙烯腈衍生滤器持续肾脏替代治疗对卡泊芬素浓度影响的回顾性研究。

caspofunins在危重患者中可能会改变药代动力学。体外研究表明，在持续肾替代治疗（CRRT）期间，聚丙烯腈（PAN）膜对药物有显著的吸附作用。方法：本研究回顾性分析了2021年至2024年间35例ICU患者的66例血浆casfunins浓度（pCASconc），比较了PAN-CRRT组（n = 19）和未行PAN-CRRT组（n = 47）。结果：卡泊芬净主要用于念珠菌感染（40%）和侵袭性念珠菌感染（25.7%）。12 h时各组pCASconc中位数相似，但18和24 h时，PAN-CRRT组pCASconc中位数显著高于对照组[5.3 (4.1-6.9)vs. 3.3 (1.9-3.7) mg/L, p = 0.04; 5.3 (3.9-5.8) vs. 3.1 (2.5-4.5) mg/L, p = 0.01]。PAN-CRRT患者使用ECMO的频率更高（75%比21.7%,p = 0.01）。3例患者发生持续性念珠菌感染（PAN-CRRT组1例，非PAN-CRRT组2例）。结论：本研究未发现PAN-CRRT减少caspofungin的证据，值得进一步研究临床结果。

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来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.