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Antifungals under- and over-dosing are frequently deplored in patients treated with antifungals and receiving recommended doses, mostly in critically-ill patients. This situation is well-described for antifungals from the azoles class mostly in patients with liver dysfunction or having concomitant drugs that may interact with azoles. This situation is less-described using echinocandins, although recent studies reported caspofungin underdosing for critically-ill patients. Considering that antifungals under-dosing was demonstrated to be associated with an increase in mortality, it is of utmost importance to analyse the relevance of therapeutic drug monitoring (TDM) for patients admitted in intensive care units (ICU). This will help to identify which patients are the more prone to antifungal under or over-dosing. Indeed, antifungals under-dosing may favour the development of clinical resistance to antifungals and increase mortality, whereas over-dosing may result in adverse events that may lead to treatment discontinuation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Antifungal treatment | Patients receiving antifungal treatment during their stay in Intensive Care Unit |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Antifungal treatment | Drug | Treatment by fluconazole, voriconazole,posaconazole or caspofungin during the patient stay in Intensive Care Unit |
|
| Measure | Description | Time Frame |
|---|---|---|
| Antifungal blood concentration of patients admitted in intensive care units | Day 5 after antifungal initiation |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse event | Impact of antifungal blood concentration on occurrence of adverse events and mycological failure | Day 30 after antifungal initiation |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who received antifungals during their ICU stay and had a TDM
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civils de Lyon, Croix-Rousse Hospital | Lyon | 69004 | France |
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