Voriconazole Therapeutic Drug Level Monitoring: A University Hospital Experience


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KARA E., BAKIR EKİNCİ P., METAN G., EKİNCİOĞLU A., PINAR A., AKOVA M., ...Daha Fazla

FLORA INFEKSIYON HASTALIKLARI VE KLINIK MIKROBIYOLOJI DERGISI, cilt.27, sa.1, ss.183-188, 2022 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 27 Sayı: 1
  • Basım Tarihi: 2022
  • Doi Numarası: 10.5578/flora.20229914
  • Dergi Adı: FLORA INFEKSIYON HASTALIKLARI VE KLINIK MIKROBIYOLOJI DERGISI
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.183-188
  • Anahtar Kelimeler: Voricanazole, Therapeutic, Drug monitoring, Antifungal
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Interindividual pharmacokinetic changes are frequently observed in voriconazole therapy, therefore, routine serum trough level monitoring is recommended. In this study, patients treated with voriconazole were evaluated and the effects of monitoring voriconazole levels on the antifungal treatment method were investigated. Patients aged 18 years and older who were treated with voriconazole between January 2019 and November 2020 in a tertiary university hospital were included in this study. In addition to the demographic information of the patients, voriconazole level monitoring, level results, and data on antifungal treatment were analyzed. During the study, voriconazole treatment was given to 70 patients with a median age of 55.5 (20-87) years and 21 (30%) women. 87.1% of voriconazole treatments were administered parenterally. 31 (44.3%) were treated with voriconazole before the start of voriconazole level monitoring in the hospital, and 39 (55.7%) after the therapeutic drug level monitoring was started. In the post-level monitoring period, a total of 88 voriconazole plasma levels were monitored in 34 (87.2%) patients, the median (minimum-maximum) number of monitorings per patient was 2 (1-8). The voriconazole levels were 51.1% therapeutic 15.9% subtherapeutic, and 33% supratherapeutic. After level monitoring, 30 interventions were performed, the most common interventions being a reduction of voriconazole dose (n= 11, 42.3%) and switching to oral therapy (n= 8, 26.7%). This study reveals that therapeutic drug level monitoring in voriconazole treatment can be effectively adapted to hospital practice and that this practice is an important approach to provide optimum treatment.