Date:

2025-04-30

Title of Paper:

A sensitive ultra-performance liquid chromatography-tandem mass spectrometry method to monitor caspofungin trough plasma concentrations and association between troughs and efficacy in intensive care u

Journal:

RSC Advances

Summary:

Caspofungin is a common treatment for fungal infections in intensive care unit (ICU) patients, and in these patients their pharmacokinetics are highly variable. So a rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established for measuringCminin 18 ICU patients, and the exposure–response characteristics of caspofungin were investigated. The calibration curve included clinically relevant caspofungin concentrations, ranging from 0.05 to 20 mg L611. The mean recovery rate ranged from 85.2% to 95.3%, while the intra- and interday precisions were <5.5% and their accuracies were within the range of 96.2–102.3%. The overallCminwas 2.13 ± 0.99 mg L611(mean ± SD; range, 0.51–3.79 mg L611). Patients were infected by eitherCandidaspp. (n= 13) orAspergillusspp. (n= 5), and caspofungin therapy was effective in 66.7% (n= 12) of them. 76.9% (10/13) patients (infected byCandidaspp. andCmin> 1 mg L611) achieved clinical success while 23.1% (3/13) patients (Cmin> 1 mg L611:n= 1;Cmin< 1 mg L611:n= 2) failed to show a clinical response. All five patients infected byAspergillusspp. had a mean plasmaCminabove 0.5 mg L611, and only two achieved clinical success. Validated LC-MS/MS is a simple, rapid and accurate method that is suitable for monitoring the concentration of caspofungin.Cminexhibits a wide range in ICU patients, and relatively good treatment results are obtainable whenCminexceeds the 90% minimal inhibitory concentration (Candidaspp: 1 mg L611;Aspergillusspp: 0.5 mg L611).

Co-author:

Qianting Yang, Yalin Dong*

Translation or Not:

No

Date of Publication:

2015-11-24