Voriconazole Therapeutic Drug Monitoring in Patients with Invasive Mycoses Improves Efficacy and Safety Outcomes

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ID: 301808
2007
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Ranked #508 of 531 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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Abstract
Voriconazole is the therapy of choice for aspergillosis and a new treatment option for candidiasis. Liver disease, age, genetic polymorphism of the cytochrome CYP2C19, and comedications influence voriconazole metabolism. Large variations in voriconazole pharmacokinetics may be associated with decreased efficacy or with toxicity.This study was conducted to assess the utility of measuring voriconazole blood levels with individualized dose adjustments.A total of 181 measurements with high-pressure liquid chromatography were performed during 2388 treatment days in 52 patients. A large variability in voriconazole trough blood levels was observed, ranging from 5.5 mg/L (a level possibly associated with toxicity) in 31% of cases. Lack of response to therapy was more frequent in patients with voriconazole levels 1 mg/L (15 [12%] of 39 patients; P=.02). Blood levels >1 mg/L were reached after increasing the voriconazole dosage, with complete resolution of infection in all 6 cases. Among 16 patients with voriconazole trough blood levels >5.5 mg/L, 5 patients (31%) presented with an encephalopathy, including 4 patients who were treated intravenously with a median voriconazole dosage of 8 mg/kg per day, whereas none of the patients with levels
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openalex_W2162857158 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Andrés Pascual, Thierry Calandra, S. Bolay, Thierry Buclin, J. Bille, Oscar Marchetti
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2007
DOI
10.1086/524669
URL
https://doi.org/10.1086/524669
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