Abstract
Invasive candidiasis was the most common nosocomial fungal infection with high morbidity and mortality, which is mainly occurring in immunodeficiency and critical patients. Echinocandins were recommended as first-line drugs for the treatment and prevention of invasive candidiasis. In our study, we aimed to optimize the dosage of Rezafungin against Candida spp. based on pharmacokinetic/pharmacodynamics (PK/PD) analysis. We collected the published data about pharmacokinetic parameters of rezafungin and the MIC distribution of Candida spp. on rezafungin. Monte Carlo simulation was used to calculate probability of target attainment and a cumulative fraction of response to assess the best dosing regimen. The optimal dosage regimen for C. albicans and C. glabrata was 50 mg IV, and the optimal dosage regimen for C. parapsilosis was 100 mg IV. Lastly, rezafungin has an excellent antifungal effect on C. albicans, C. glabrata and C. parapsilosis.
Highlights
Invasive candidiasis has the most common nosocomial fungal infections, mainly in immunodeficiency and critically ill patients, with high morbidity and mortality
The results showed that probability of target attainment (PTA) values were more than 90% for C. albicans when Minimum Inhibition Concentration (MIC) was less than 0.25 μg/ml in each dosing regimen
As C. parapsilosis for PTA with more than 90%, MIC of rezafungin 50 mg, 100 mg, 200 mg and 400 mg were less than 1 μg/ml, 2 μg/ml, 4 μg/ml and 4 μg/ml, respectively
Summary
Invasive candidiasis has the most common nosocomial fungal infections, mainly in immunodeficiency and critically ill patients, with high morbidity and mortality. Some studies reported that patients were diagnosed with invasive candidiasis, which mortality rate is 35% at 12 weeks, even as high as 50% [1] [2]. Since 2009, Echinocandins have been recommended as first-line drugs for the treat-.
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