Assessment of plasma voriconazole concentrations in clinical practice
DOI:
https://doi.org/10.30827/ars.v62i3.20756Keywords:
antifungal, aspergillosis, clinical practice guideline, plasma concentration, therapeutic drug monitoring, voriconazoleAbstract
Introduction: Voriconazole presents a high interindividual variability in plasma concentrations. We aimed to: (i) describe plasma voriconazole concentrations (PVC) of an adult cohort, (ii) identify potential causes of variability and (iii) relate them with current pharmacokinetic monitoring recommendations.
Method: Observational retrospective study. All patients with at least one determination of PVC during 2017 were included.
Results: A total of 165 trough concentrations (Ctrough) were analyzed from 51 patients. The median Ctrough was 2.4µg/mL (IQR:1.4-3.6). Ctrough were <1µg/mL in 26 cases and >4 µg/mL in 34. Significantly higher concentrations were observed in patients older than 65 years (p=0.006) and in patients with albumin levels <27g/L (p<0.001). Following PVC’s monitoring recommendation from ESCMID-ECMM-ERS’s guideline, we would detect the 91.1% of Ctrough out of the interval.
Conclusions: We observed 36.4% of PVC outside of its optimal range. We identified age and albumin concentration as factors that influence PVC.
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