In infants with candidiasis, there is no significant relationship between exposure to micafungin and mycologic response, according to results published in The Pediatric Infectious Disease Journal.
Despite these results, pharmacokinetic (PK)-pharmacodynamic (PD) experiments support higher exposures of micafungin in infants with invasive candidiasis.
The study included infants 3 to 119 days old (n=64). The researchers used micafungin plasma concentrations from the participants to construct a population PK model using Pmetrics™ software. They used Bayesian posterior estimates for participants with invasive candidiasis to evaluate the relationship between drug exposure and mycologic response using logistic regression. Of the 64 infants, 45% (n=29) had invasive candidiasis.
The mean (standard deviation) estimates for clearance and volume in the central compartment were 0.07 (0.05) L/h/1.8 kg and 0.61 (0.53) L/1.8 kg, respectively.
The results indicated that there was no relationship between average daily area under concentration-time curve or average daily area under concentration-time curve and minimum inhibitory concentration ratio and mycologic response (P >.05).
Although not statistically significant, the researchers found that mycologic response was numerically higher when area under concentration-time curves were at or above the PD target.
“While a significant exposure-response relationship was not found, PK-PD experiments support higher exposures of micafungin in infants with invasive candidiasis,” the researchers wrote.
Kovanda LL, Walsh TJ, Benjamin DK Jr, et al. Exposure-response analysis of micafungin in neonatal candidiasis. Pediatr Infect Dis J. 2018;37:580-585.