Skip to main content

Pharmacokinetics and Safety of Micafungin in Infants Supported With Extracorporeal Membrane Oxygenation.

Publication ,  Journal Article
Autmizguine, J; Hornik, CP; Benjamin, DK; Brouwer, KLR; Hupp, SR; Cohen-Wolkowiez, M; Watt, KM
Published in: Pediatr Infect Dis J
November 2016

BACKGROUND: Candida is a leading cause of infection in infants on extracorporeal membrane oxygenation (ECMO). Optimal micafungin dosing is unknown in this population because ECMO can alter drug pharmacokinetics (PK). METHODS: To characterize micafungin pharmacokinetics and safety in infants on ECMO, we conducted an open-label pharmacokinetics trial. Infants on ECMO either received intravenous micafungin 4 mg/kg every 24 h for invasive candidiasis prophylaxis or 8 mg/kg every 24 h when a fungal infection was suspected or confirmed. We collected plasma samples after single and multiple micafungin doses. We defined the therapeutic target as the adult exposure associated with efficacy in phase III trials and the prophylactic target as one-half of the therapeutic target. RESULTS: We enrolled 12 infants (124 samples) with a median age of 59 days. Using a 1-compartment model, median weight-normalized volume of distribution and clearance were 0.64 L/kg and 0.041 L/kg/h, respectively. Dose-exposure simulations revealed that doses of 2.5 and 5 mg/kg every 24 h matched exposure targets for prophylaxis and treatment of invasive candidiasis, respectively. We did not observe any drug-related adverse events. CONCLUSIONS: In infants on ECMO, micafungin volume of distribution was higher and clearance was in the upper range of previously published values for infants not on ECMO. Based on these data, we recommend dosing of 2.5 and 5 mg/kg every 24 h for prophylaxis and treatment of invasive candidiasis, respectively, to match adult exposure proven effective against Candida spp.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

November 2016

Volume

35

Issue

11

Start / End Page

1204 / 1210

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pediatrics
  • Micafungin
  • Male
  • Lipopeptides
  • Infant, Newborn
  • Infant
  • Humans
  • Female
  • Extracorporeal Membrane Oxygenation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Autmizguine, J., Hornik, C. P., Benjamin, D. K., Brouwer, K. L. R., Hupp, S. R., Cohen-Wolkowiez, M., & Watt, K. M. (2016). Pharmacokinetics and Safety of Micafungin in Infants Supported With Extracorporeal Membrane Oxygenation. Pediatr Infect Dis J, 35(11), 1204–1210. https://doi.org/10.1097/INF.0000000000001268
Autmizguine, Julie, Christoph P. Hornik, Daniel K. Benjamin, Kim L. R. Brouwer, Susan R. Hupp, Michael Cohen-Wolkowiez, and Kevin M. Watt. “Pharmacokinetics and Safety of Micafungin in Infants Supported With Extracorporeal Membrane Oxygenation.Pediatr Infect Dis J 35, no. 11 (November 2016): 1204–10. https://doi.org/10.1097/INF.0000000000001268.
Autmizguine J, Hornik CP, Benjamin DK, Brouwer KLR, Hupp SR, Cohen-Wolkowiez M, et al. Pharmacokinetics and Safety of Micafungin in Infants Supported With Extracorporeal Membrane Oxygenation. Pediatr Infect Dis J. 2016 Nov;35(11):1204–10.
Autmizguine, Julie, et al. “Pharmacokinetics and Safety of Micafungin in Infants Supported With Extracorporeal Membrane Oxygenation.Pediatr Infect Dis J, vol. 35, no. 11, Nov. 2016, pp. 1204–10. Pubmed, doi:10.1097/INF.0000000000001268.
Autmizguine J, Hornik CP, Benjamin DK, Brouwer KLR, Hupp SR, Cohen-Wolkowiez M, Watt KM. Pharmacokinetics and Safety of Micafungin in Infants Supported With Extracorporeal Membrane Oxygenation. Pediatr Infect Dis J. 2016 Nov;35(11):1204–1210.

Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

November 2016

Volume

35

Issue

11

Start / End Page

1204 / 1210

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pediatrics
  • Micafungin
  • Male
  • Lipopeptides
  • Infant, Newborn
  • Infant
  • Humans
  • Female
  • Extracorporeal Membrane Oxygenation