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.

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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