International journal of antimicrobial agents
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Int. J. Antimicrob. Agents · Feb 2015
Is hepatitis C virus eradication around the corner only 25 years after its discovery?
Hepatitis C virus (HCV), identified approximately 25 years ago, is recognised as the cause of several clinical conditions besides chronic hepatitis. New compounds with direct antiviral activity have recently been introduced. ⋯ In fact, these drugs may pave the way to complete eradication of the disease. However, their actual price is exceedingly high and a strategy is necessary to guarantee wide and sustainable access to new therapies.
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Int. J. Antimicrob. Agents · Feb 2015
Pharmacokinetics of fluconazole in critically ill patients with acute kidney injury receiving sustained low-efficiency diafiltration.
Fluconazole is a widely used antifungal agent in critically ill patients. It is predominantly (60-80%) excreted unchanged in urine. Sustained low-efficiency diafiltration (SLED-f) is increasingly being utilised in critically ill patients because of its practical advantages over continuous renal replacement therapy. ⋯ CL and AUC0-24 were comparable with previous observations in a pre-dilution mode of continuous venovenous haemodiafiltration. The observed rebound concentration of fluconazole post SLED-f was <2%. Although a definitive dosing recommendation is not possible due to the small patient number, it is clear that doses >200mg daily are likely to be required to achieve the PK/PD target for common pathogens because of significant fluconazole clearance by SLED-f.