Clinical validation of antifungal dosing strategies in critically ill patients

It has been shown in previous studies that the exposure to some antifungal drugs is insufficient in (a subgroup of) critically ill patients. It is known that an adequate target attainment leads to a significantly better outcome so underexposure can be dangerous, certainly in this severely ill patient population. In this research project, stratified dosing regimens will be developed, using mathematical models, to optimize the exposure to two antifungal drugs: fluconazole and liposomal amphotericin B. These new dosing strategies will be validated in two prospective pharmacokinetic studies. The primary objective of these studies is to show sustained target attainment based on measured plasma concentrations. Secondary objectives are improved clinical outcomes associated with this increased target attainment, without causing more treatment-related adverse events. In another work package, an optimal prophylaxis and treatment strategy against both influenza and Covid-19 associated invasive pulmonary aspergillosis, will be validated in a prospective, clinical study.

Keywords:Antifungal drugs, Pharmacokinetics, Target attainment, Dosing regimens, Invasive aspergillosis

Disciplines:Clinical trials, Pharmacodynamics, Pharmacokinetics, Clinical pharmacy, Pharmacotherapy