{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:34:56Z","timestamp":1791480896551,"version":"4.3.4"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"The Prince Charles Hospital Research Foundation; ANZIC Foundation; ANZ College of Anaesthetists"},{"name":"SHPA; NHMRC Australia"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2024,1,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            This multicenter study describes the population pharmacokinetics (PK) of fluconazole in critically ill patients receiving concomitant extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) and includes an evaluation of different fluconazole dosing regimens for achievement of target exposure associated with maximal efficacy. Serial blood samples were obtained from critically ill patients on ECMO and CRRT receiving fluconazole. Total fluconazole concentrations were measured in plasma using a validated chromatographic assay. A population PK model was developed and Monte Carlo dosing simulations were performed using Pmetrics in R. The probability of target attainment (PTA) of various dosing regimens to achieve fluconazole area under the curve to minimal inhibitory concentration ratio (AUC\n            <jats:sub>0-24<\/jats:sub>\n            \/MIC) &gt;100 was estimated. Eight critically ill patients receiving concomitant ECMO and CRRT were included. A two-compartment model including total body weight as a covariate on clearance adequately described the data. The mean (\u00b1standard deviation, SD) clearance and volume of distribution were 2.87 \u00b1 0.63 L\/h and 15.90 \u00b1 13.29 L, respectively. Dosing simulations showed that current guidelines (initial loading dose of 12 mg\/kg then 6 mg\/kg q24h) achieved &gt;90% of PTA for a MIC up to 1 mg\/L. None of the tested dosing regimens achieved 90% of PTA for MIC above 2 mg\/L. Current fluconazole dosing regimen guidelines achieved &gt;90% PTA only for Candida species with MIC &lt;1 mg\/L and thus should be only used for Candida-documented infections in critically ill patients receiving concomitant ECMO and CRRT. Total body weight should be considered for fluconazole dose.\n          <\/jats:p>","DOI":"10.1128\/aac.01201-23","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T14:00:20Z","timestamp":1702044020000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":13,"title":["Population pharmacokinetics of fluconazole in critically ill patients receiving extracorporeal membrane oxygenation and continuous renal replacement therapy: an ASAP ECMO study"],"prefix":"10.1128","volume":"68","author":[{"given":"Emmanuel","family":"Novy","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), The University of Queensland , Brisbane, Queensland, Australia"},{"name":"Universit\u00e9 de Lorraine, SIMPA , Nancy, France"},{"name":"Departement of anesthesiology, Critical care and peri-operative medicine, University hospital of Nancy , 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