Validation of Heel Stick Microsampling To Optimize Micafungin Doses in Neonates and Young Infants

Antimicrob Agents Chemother. 2018 Sep 24;62(10):e01199-18. doi: 10.1128/AAC.01199-18. Print 2018 Oct.

Abstract

Major gaps exist in our knowledge of antimicrobial pharmacokinetics in critically ill neonates and infants that require validated microsampling and bioanalysis methods to support therapeutic drug monitoring. We compared serially collected intravenous (i.v.) and heel stick capillary (HSC)-sampled plasma concentrations of micafungin (8 mg/kg) in eight infants born preterm with systemic candidiasis. The mean (standard deviation) micafungin area under the plasma concentration-time curve to infinity (AUCinf) was 316 (65.0) h · mg/liter based on HSC concentrations that strongly correlated (R2 = 0.92) with i.v. values to support dose adjustment.

Keywords: antifungal agents; antimicrobial agents; candidiasis; echinocandin; heel stick; micafungin; microsampling; neonates; pediatric; pharmacodynamics; pharmacokinetics; systemic candidiasis.

MeSH terms

  • Antifungal Agents / pharmacokinetics*
  • Area Under Curve
  • Candidiasis / blood*
  • Chromatography, High Pressure Liquid
  • Critical Illness
  • Humans
  • Infant
  • Infant, Newborn
  • Micafungin / pharmacokinetics*
  • Prospective Studies

Substances

  • Antifungal Agents
  • Micafungin

Supplementary concepts

  • Systemic candidiasis