Analysis Of Influencing Factors Of Micafungin Peak/trough Concentration In ICU Patients With Sepsis

Objective: To observe the peak/trough concentration of micafungin at steady state in ICU sepsis patients at different doses,and to analyze the factors influencing the peak/trough concentration of micafungin in steady state,so as to better guide clinical anti-infective treatment.Methods: Blood samples were collected twice immediately(0h)after the 4th(±1)administration of micafungin in ICU patients with sepsis and 24 h before the next administration.The plasma concentration of micafungin was determined by high performance liquid chromatography(HPLC).Clinical data collection,sepsis-related organ failure(SOFA)score,Child-Pugh score of liver function,acute physiology and chronic health(APACHE II)score were performed to analyze the factors affecting peak/trough concentration of micafungin at steady state.Rusults: The steady-state peak concentration of micafungin was negatively correlated with body weight,positively correlated with APACHE II,positively correlated with SOFA score,but not correlated with BMI,albumin,Child-Pugh score of liver function,serum creatinine and endogenous creatinine clearance rate.There was no correlation between steady trough concentration and the above indexes.The average peak concentration of 150 mg/d group after the first day dose of 200 mg was significantly higher than that of 100 mg/d group and 100 mg/d group after the first day dose of 150 mg/d group.The steady-state peak concentration in SOFA score(?10)group was significantly higher than that in SOFA score(<10)group.The steady-state peak concentration in the group with body weight < 70 kg was significantly higher than that in the group with body weight?70kg.The steady-state peak concentration,APACHE II score,SOFA score and Child-Pugh score of the effective group were lower than those of the ineffective group.There was no significant difference in the steady trough concentration between the two groups(P>0.05).Conclusions: The steady-state peak concentration of micafungin in ICU sepsis patients was correlated with body weight,APCHE II score and SOFA score,while the steady-state trough concentration was correlated with the steady-state peak concentration,but not with other factors.When the SOFA score<10 and body weight?70kg,the steady peak concentration of micafungin was lower.It might be necessary to increase the dose for better clinical efficacy.Monitoring the steady-state peak concentration of micafungin in ICU sepsis patients may provide a basis for clinical treatment.