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Antifungal drug penetration in soft tissue abscesses: a comparative analysis.

Authors :
Costa, Alicia Cancela
Kritikos, Antonios
Glampedakis, Emmanouil
Clara, Jorge Da Silva Pereira
Schaller, Fabian
Mercier, Thomas
Strasser, Roland
Balmpouzis, Zisis
Koutsokera, Angela
Manuel, Oriol
Buclin, Thierry
Decosterd, Laurent Arthur
Lamoth, Frederic
Source :
Journal of Antimicrobial Chemotherapy (JAC); Jul2024, Vol. 79 Issue 7, p1668-1672, 5p
Publication Year :
2024

Abstract

Background Invasive fungal infections (IFIs) are severe and difficult-to-treat infections affecting immunocompromised patients. Antifungal drug penetration at the site of infection is critical for outcome and may be difficult to achieve. Data about antifungal drug distribution in infected human tissues under real circumstances of IFI are scarce. Methods Multiple samples were obtained from soft tissue abscesses of a lung transplant patient with Candida albicans invasive candidiasis who underwent recurrent procedures of drainage, while receiving different consecutive courses of antifungal therapy [itraconazole (ITC), fluconazole, caspofungin]. Antifungal drug concentrations were measured simultaneously at the site of infection (surrounding inflammatory tissue and fluid content of the abscess) and in plasma for calculation of the tissue/plasma ratio (R). The concentration within the infected tissue was interpreted as appropriate if it was equal or superior to the MIC of the causal pathogen. Results A total of 30 tissue samples were collected for measurements of ITC (n  = 12), fluconazole (n  = 17) and caspofungin (n  = 1). Variable concentrations were observed in the surrounding tissue of the lesions with median R of 2.79 (range 0.51–15.9) for ITC and 0.94 (0.21–1.37) for fluconazole. Concentrations ranges within the fluid content of the abscesses were 0.39–1.83 for ITC, 0.66–1.02 for fluconazole and 0.23 (single value) for caspofungin. The pharmacodynamic target (tissue concentration ≥ MIC) was achieved in all samples for all three antifungal drugs. Conclusions This unique dataset of antifungal drug penetration in infected human soft tissue abscesses suggests that ITC, fluconazole and caspofungin could achieve appropriate concentrations in soft tissue abscesses. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03057453
Volume :
79
Issue :
7
Database :
Complementary Index
Journal :
Journal of Antimicrobial Chemotherapy (JAC)
Publication Type :
Academic Journal
Accession number :
178184801
Full Text :
https://doi.org/10.1093/jac/dkae162