Abstract | BACKGROUND: Case reports and pharmacokinetic data suggest off-label echinocandin dosing may be needed to reach adequate serum concentrations in obese patients. Few outcome studies exist evaluating this population. OBJECTIVES: METHODS: A retrospective cohort was conducted to evaluate hospitalized patients treated for candidemia with anidulafungin at Food and Drug Administration-labeled dosing for at least 72 hours from January 1, 2014, through January 31, 2018. Candidemia was diagnosed by blood culture or T2 magnetic resonance (T2MR). Patients were compared according to BMI category. RESULTS: One hundred seventy-three patients were included. Candida albicans and Candida glabrata were identified in 58 (33%) and 57 (33%) patients, respectively. Mortality was comparable according to BMI category: 4 (36.4%) underweight, 8 (25.8%) normal weight, 16 (32.0%) overweight, 20 (33.9%) obese, and 7 (31.8%) morbidly obese, P = .976. Variables associated with mortality included: severe sepsis (adjusted odds ratio [OR] = 5.1, 95% CI: 1.7-14.8) and liver disease (adjusted OR = 3.2, 95% CI: 1.1-9.4). Variables that were protective of mortality included: line removal (adjusted OR = 0.05, 95% CI: 0.02-0.2) and receipt of anidulafungin for at least 5 days (adjusted OR = 0.35, 95% CI: 0.15-0.8). CONCLUSION: There was no difference detected in mortality among patients with candidemia across BMI category. Larger studies are needed to confirm whether standard doses of anidulafungin are sufficient for candidemia in obese patients.
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Authors | Mary Hutton, Rachel M Kenney, Jose A Vazquez, Susan L Davis |
Journal | Journal of pharmacy practice
(J Pharm Pract)
Vol. 35
Issue 1
Pg. 20-25
(Feb 2022)
ISSN: 1531-1937 [Electronic] United States |
PMID | 32648506
(Publication Type: Journal Article)
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Chemical References |
- Antifungal Agents
- Anidulafungin
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Topics |
- Anidulafungin
- Antifungal Agents
(therapeutic use)
- Candida
- Candidemia
(diagnosis, drug therapy, epidemiology)
- Humans
- Obesity, Morbid
(drug therapy)
- Retrospective Studies
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