Caspofungin, aechinocandin, is a relatively new lipophilic antifungal drug. Little is known concerning the pharmacokinetics of caspofungin in children. Extracorporeal membrane oxygenation (ECMO) allows prolonged cardiopulmonary support in patients with life-threatening respiratory or cardiac failure. Pharmacokinetics may be altered by ECMO. We describe the case of a paediatric patient on ECMO with severe pneumonia and sepsis, who had subtherapeutic exposure of caspofungin despite normal to high dosages of caspofungin. Therapeutic drug monitoring is warranted.

Aspergillosis, Candidiasis, Pharmacokinetics, Pneumonia, Therapeutic drug monitoring,
Medical Mycology Case Reports
Department of Pediatrics

Koch, B.C.P, Wildschut, E.D, de Goede, A.L, de Hoog, M, & Brüggemann, M. (2013). Insufficient serum caspofungin levels in a paediatric patient on ECMO. Medical Mycology Case Reports, 2(1), 23–24. doi:10.1016/j.mmcr.2012.12.006