Pharmacokinetics of anidulafungin in pleural fluid during the treatment of a patient with Candida empyema

Abstract

Candida empyema is a serious complication of disseminated candidiasis. However, little is known about the intrapleural pharmacokinetics of echinocandins. We report the penetration of anidulafungin into the pleural fluid of a patient with Candida tropicalis empyema. The anidulafungin ratio for the area under the concentration-time curve from 0 h to the last measurement between pleural fluid and serum values was only 0.125 (12.5%), with pleural fluid concentrations ranging between 0.67 and 0.88 μg/ml.

Fig. 1.

Serum and pleural fluid concentration-versus-time profiles of a dose of anidulafungin (100 mg i.v. every 24 h; an actual dose of 88.62 mg was delivered on the day of pharmacokinetic sampling due to drug left in the intravenous tubing).