Antifungal dose adjustment in renal and hepatic dysfunction: Pharmacokinetic and pharmacodynamic considerations

Jason M. Cota, David S. Burgess

    Research output: Contribution to journalReview articlepeer-review

    9 Scopus citations

    Abstract

    Adjusting the dose of antifungal agents for renal and hepatic impairment can be challenging given that clinicians must rely on limited pharmacokinetic data to derive specific regimens. These pharmacokinetic studies are typically performed in a small number of patients without invasive fungal infection, and results are not often reported in concert with accepted pharmacodynamic indices. This article aims to review pertinent pharmacokinetic studies of antifungal drugs in patients with renal or hepatic dysfunction. The impact of novel continuous renal replacement therapy techniques on the pharmacokinetic disposition of antifungal agents will also be described where data are available. Subsequently, this review provides recommendations for antifungal drug dosing in patients with kidney or liver dysfunction after accounting for established or emerging pharmacokinetic-pharmacodynamic relationships as they relate to antifungal drug efficacy in vivo.

    Original languageEnglish (US)
    Pages (from-to)120-128
    Number of pages9
    JournalCurrent Fungal Infection Reports
    Volume4
    Issue number2
    DOIs
    StatePublished - Jun 1 2010

    Keywords

    • Antifungal drugs
    • Dosage
    • Echinocandins
    • Kidney dysfunction
    • Liver dysfunction
    • Renal replacement therapy
    • Triazoles

    ASJC Scopus subject areas

    • Infectious Diseases

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