Suboptimal Dosing of Fluconazole in Critically Ill Patients: Time To Rethink Dosing
Eline W. Muilwijk, Dylan W. de Lange, Jeroen Schouten, Roeland E. Wasmann, Rob ter Heine, David M. Burger, Angela Colbers, P. J. A. Haas, Paul E. Verweij, Peter Pickkers, Roger J. M. Brüggemann
Abstract
AUC (area under the concentration-time curve for the free, unbound fraction of the drug)/MIC ratio of 100. In conclusion, fluconazole clearance is highly variable in ICU patients and is strongly dependent on renal function and CRRT. Trough concentrations correlated well with the AUC, opening up opportunities for tailored dosing using therapeutic drug monitoring. We recommend doses of 400 mg for patients with poor to moderate renal function, 600 mg for patients with adequate renal function, and 800 mg for patients treated with CRRT. (This study has been registered at ClinicalTrials.gov under identifier NCT02666716.).