Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Antimicrob Agents Chemother. 2013 Nov;57(11):5714-6. doi: 10.1128/AAC.01057-13. Epub 2013 Aug 19.
Echinocandins exhibit concentration-dependent effects on Candida species, and preclinical studies support the administration of large, infrequent doses. The current report examines the pharmacokinetics/pharmacodynamics of two multicenter, randomized trials of micafungin dosing regimens that differed in both dose level and dosing interval. Analysis demonstrates the clinical relevance of the dose level and area under the concentration-time curve (AUC). Better, although not statistically significant (P = 0.056), outcomes were seen with higher maximum concentrations of drug in serum (Cmax) and large, infrequent doses. The results support further clinical investigation of novel micafungin dosing regimens with large doses but less than daily administration. (These studies have been registered at ClinicalTrials.gov under registration no. NCT00666185 and NCT00665639.).
棘白菌素类药物对念珠菌属呈浓度依赖性作用，临床前研究支持大剂量、间隔给药。本报告分析了两种两性霉素 B 脂质体剂量方案的药代动力学/药效学多中心随机对照试验，两种方案在剂量水平和给药间隔方面均有不同。分析结果表明剂量水平和浓度-时间曲线下面积（AUC）与临床疗效相关。虽然无统计学意义（P = 0.056），但血清药物最大浓度（Cmax）和大剂量、间隔给药可获得更好的疗效。该结果支持进一步研究新型棘白菌素类药物大剂量但低于每日给药的方案。（这些研究已在 ClinicalTrials.gov 注册，注册号分别为 NCT00666185 和 NCT00665639。）
