Continuous renal replacement therapy (CRRT): Consider delayed administration of concurrent echinocandins

The Medicines and Healthcare products Regulatory Agency (MHRA) has published device safety information for Continuous renal replacement therapy (CRRT). CRRT is used for managing severe acute kidney injury and fluid overload. Published evidence has shown that caspofungin can bind to polyacrylonitrile (PAN)-based membranes used in CRRT which may result in ineffective antifungal treatment with potentially life-threatening consequences in critically ill patients.

It is considered that the potential risk is greatest when a new membrane or filter circuit has commenced. Where possible, it is recommended that echinocandins such as caspofungin, and similar drugs, are administered at least six hours after initiation of PAN-based filter use, and after filter circuit set changes.

Further information and advice can be found on the MHRA website.