AFG (Ecalta®; Pfizer, Sandwich, Kent, UK), MFG (Mycamine®; Astellas, Leiderdorp, NL), and CAS (Cancidas®; Merck Sharp and Dohme, Hoddesdon, Hertfordshire, UK), respectively, were administered at the discretion of the treating physician. As recommended by the manufacturer, the daily maintenance dose of AFG amounted to 100 mg after a 200-mg loading dose. MFG was given at a daily dose of 100 mg. The standard maintenance dose of CAS is 50 mg daily after a single-loading dose of 70 mg. Patients with a body weight above 80 kg should receive 70 mg daily during the entire treatment.
Cancidas
Manufactured by Merck Group
Sourced in United Kingdom, China, Germany
Cancidas is a laboratory equipment product manufactured by Merck Group. It is designed for use in research and development settings. The core function of Cancidas is to facilitate controlled and precise sample preparation and processing.
Automatically generated - may contain errors
Lab products found in correlation
Ecalta, by Pfizer (2 mentions)
Caspofungin acetate, by Merck Group (1 mentions)
Diflucan, by Pfizer (1 mentions)
Rpmi 1640, by Merck Group (1 mentions)
Cycloheximide (chx), by Merck Group (1 mentions)
Fluconazole, by B. Braun (1 mentions)
Caspofungin, by Merck Group (1 mentions)
Fluorescent brightener 28, by Merck Group (1 mentions)
5 protocols using cancidas
1
Antifungal Dosing Regimens Comparison
2
Optimizing Voriconazole Regimen for IPA in ACLF
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Anti-fungal therapies for ACLF patients complicated with IPA have evolved in our Hepatology Unit. In the first few years (2011–2014), our patients were treated with echinocandins (Cancidas, caspofungin acetate, Merck) or standard voriconazole (voriconazole tablet, 50 milligrams/tablet; Huashen, Chendu, PR China) dosage (loading dose as 0.4 g, po, q12h, maintenance dose as 0.2 g, po, q12h, which was adjusted mainly based on overt clinical adverse effects).
In October 2014, plasma voriconazole concentrations monitoring tests became available in our hospital. We then began to explore an optimal voriconazole regimen based on the plasma drug level (Supplementary material: Voriconazole monitoring protocol). Finally, an optimal voriconazole regimen was established, which consisted of a lower loading dose (0.2 g, po, q12h) and a lower maintenance dose (0.1 g, po, qd), and this optimal regimen turned to be the preferred anti-fungal option for the majority of the subsequent IPA cases with underlying ACLF.
In October 2014, plasma voriconazole concentrations monitoring tests became available in our hospital. We then began to explore an optimal voriconazole regimen based on the plasma drug level (Supplementary material: Voriconazole monitoring protocol). Finally, an optimal voriconazole regimen was established, which consisted of a lower loading dose (0.2 g, po, q12h) and a lower maintenance dose (0.1 g, po, qd), and this optimal regimen turned to be the preferred anti-fungal option for the majority of the subsequent IPA cases with underlying ACLF.
3
Antifungal Compound Preparation Protocol
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Stock solutions of the three echinocandins anidulafungin (Ecalta®, Pfizer, Illertissen, Germany), micafungin (Mycamine®, Astellas Pharma Europe, Leiden, The Netherlands) and caspofungin (Cancidas®, Merck Sharp & Dohme, Hertfordshire, UK) as well as fluconazole (Diflucan®, Pfizer) were made by reconstitution of licensed preparations according to the product information. These were diluted directly before use with distilled water and 10 µl of this dilution was added to 1 ml culture medium resulting in concentrations of 0.1–100 µg/ml. Control cultures were treated with distilled water only.
4
Candida albicans Antifungal Sensitivity Assay
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If not indicated otherwise, C. albicans strain SC5314 was used throughout all experiments. For studies on Tye7, strain SN152 tye7Δ/Δ and the corresponding wild-type strain SN152 were used (Noble and Johnson, 2005 (link); Homann et al., 2009 (link)). Pre-cultures were grown over night at 30°C in 20 ml YPD medium (per liter: 10 g yeast extract, 20 g peptone, and 20 g glucose). Cells were harvested by centrifugation at 4000 ×g, washed twice in phosphate-buffered saline (PBS) and suspended in either YPD or MOPS-buffered RPMI 1640 (Sigma) with 2% glucose (per liter: 10.4 g RPMI 1640, 34.53 g MOPS, 20 g glucose; pH 6.8; subsequently defined as RPMI medium). Stock solution of caspofungin (5 mg/ml; Cancidas®, Merck, Germany), flucytosine (10 mg/ml), cycloheximide (20 mg/ml; Sigma C7698) or sodium azide (20 mg/ml) were prepared in PBS and filter sterilized. Amphotericin B stock solution was prepared at 4 mg/ml in DMSO. Fluconazole solution at 2 mg/ml was purchased from B. Braun, Germany. All drugs were diluted in the respective media that were used for sensitivity analyses. Controls were prepared according to the solvents used for stock solutions of the respective antibiotics.
5
Cell Wall Integrity Assay for ΔperA
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