International journal of clinical pharmacy
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Observational Study
Hemodynamic changes in surgical intensive care unit patients undergoing echinocandin treatment.
Background Echinocandins are well-established agents for the treatment of patients with fungal infections, but growing evidence questions their safety in special patient populations prone to systemic inflammatory responses. Objective The study aimed to analyse early hemodynamic changes during echinocandin therapy in critically ill surgical patients. Setting The study was conducted at the surgical intensive care unit at the University Hospital of Giessen, Germany. ⋯ Secondary analysis of the combined anidulafungin/caspofungin group to the azoles group (fluconazole, voriconazole) showed a significant decrease of mean arterial pressure ≥ 10 mmHg (n = 37 [25%] vs. n = 27 [15%], OR = 1.8, p = 0.04), increased use of norepinephrine (n = 38 [26%] vs. n = 12 [7%], OR = 4.7, p ≤ 0.001), increased use of dobutamine (n = 12 [8%] vs. n = 4 [2%], OR = 3.8, p = 0.02), and the combined endpoint (n = 74 [50%] vs. n = 38 [21%], OR = 3.6, p ≤ 0.001). Conclusion Our retrospective data might demonstrate clinically relevant hemodynamic-depressing effects of anidulafungin and caspofungin. Further prospective acquisition of clinical data will be necessary to evaluate their impact on hemodynamic function.