Elimination of liposomal amphotericin by hemodiafiltration

Tomlin, Mark; Priestley, Gail

doi:10.1007/bf01711556

Cited by 13 publications

(4 citation statements)

References 5 publications

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“…Up to now, the pharmacokinetics of liposomal AMB have been studied in only one patient undergoing haemofiltration 18 and in another, haemodiafiltration. 20 Peak and trough levels were measured in one additional patient treated with CVVH. 19 No effect of haemofiltration on the pharmacokinetics of total AMB levels was found in these patients.…”

Section: Discussionmentioning

confidence: 99%

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Amphotericin B lipid formulations in critically ill patients on continuous veno-venous haemofiltration

Bellmann

Egger²,

Gritsch³

et al. 2003

Journal of Antimicrobial Chemotherapy

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Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16][17][18] Data in patients on haemofiltration, however, are very sparse and only total AMB has been measured so far. [18][19][20] Separation of liberated AMB from lipidformulated AMB for differential pharmacokinetics has not been performed.…”

Section: Introductionmentioning

confidence: 99%

Amphotericin B lipid formulations in critically ill patients on continuous veno-venous haemofiltration

Bellmann

Egger²,

Gritsch³

et al. 2003

Journal of Antimicrobial Chemotherapy

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“…In critically ill patients, lower amphotericin B plasma levels were achieved by liposomal amphotericin B than in healthy subjects or in less compromised patients [ 34 , 46 , 58 ]. Continuous veno-venous haemofiltration, haemodiafiltration and intermittent haemodialysis, did not significantly affect exposure to liposomal amphotericin B [ 34 , 46 , 58 , 59 ]. CL and AUC 0–24 h of liberated amphotericin B which is looked upon as the active amphotericin B fraction were not significantly different on and off hemofiltration.…”

Section: Amphotericin Bmentioning

confidence: 99%

Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients

2017

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IntroductionBecause of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety.Materials and methodsThis review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy.Conclusions and discussionAmphotericin B is eliminated unchanged via urine and faeces. Flucytosine and fluconazole display low protein binding and are eliminated by the kidney. Itraconazole, voriconazole, posaconazole and isavuconazole are metabolised in the liver. Azoles are substrates and inhibitors of cytochrome P450 (CYP) isoenzymes and are therefore involved in numerous drug–drug interactions. Anidulafungin is spontaneously degraded in the plasma. Caspofungin and micafungin undergo enzymatic metabolism in the liver, which is independent of CYP. Although several drug–drug interactions occur during caspofungin and micafungin treatment, echinocandins display a lower potential for drug–drug interactions. Flucytosine and azoles penetrate into most of relevant tissues. Amphotericin B accumulates in the liver and in the spleen. Its concentrations in lung and kidney are intermediate and relatively low myocardium and brain. Tissue distribution of echinocandins is similar to that of amphotericin. Combination antifungal therapy is established for cryptococcosis but controversial in other IFIs such as invasive aspergillosis and mucormycosis.

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“…Unlike FLC, the SC and the fraction eliminated in the ultrafiltrate during RRT have been reported to be very low for the various AmB formulations [54,56,57].…”

Section: Renal Replacement Therapymentioning

confidence: 94%

Using pharmacokinetics and pharmacodynamics to optimise dosing of antifungal agents in critically ill patients: a systematic review

Sinnollareddy

Peake

Roberts

et al. 2012

International Journal of Antimicrobial Agents

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Elimination of liposomal amphotericin by hemodiafiltration

Cited by 13 publications

References 5 publications

Amphotericin B lipid formulations in critically ill patients on continuous veno-venous haemofiltration

Amphotericin B lipid formulations in critically ill patients on continuous veno-venous haemofiltration

Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients

Using pharmacokinetics and pharmacodynamics to optimise dosing of antifungal agents in critically ill patients: a systematic review

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