Voriconazole serum levels measured by high-performance liquid chromatography: a monocentric study in treated patients

In this study we present the results of a therapeutic drug monitoring retrospective analysis involving 14 patients with several underlying diseases who were receiving voriconazole for the treatment of fungal infections. A simple high performance liquid chromatography assay with ultraviolet detection...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2012-05, Vol.50 (4), p.439-445
Main Authors: Gómez-López, Alicia, Cendejas-Bueno, Emilio, Cuesta, Isabel, Rodríguez, Julio García, Rodríguez-Tudela, Juan L., Gutiérrez-Altés, A., Cuenca-Estrella, Manuel
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antifungal Agents - administration & dosage
Antifungal Agents - pharmacokinetics
Child
Child, Preschool
Chromatography, High Pressure Liquid - methods
Drug Monitoring - methods
Female
Humans
Male
Middle Aged
Mycoses - drug therapy
Pyrimidines - administration & dosage
Pyrimidines - pharmacokinetics
Retrospective Studies
Serum - chemistry
Time Factors
Triazoles - administration & dosage
Triazoles - pharmacokinetics
Voriconazole
Young Adult
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Summary:In this study we present the results of a therapeutic drug monitoring retrospective analysis involving 14 patients with several underlying diseases who were receiving voriconazole for the treatment of fungal infections. A simple high performance liquid chromatography assay with ultraviolet detection was used in the drug monitoring. We report here that serum concentrations were highly variable and unpredictable in most patients. We also found that lack of response was more frequent in patients with levels persistently lower than 1 mg/l. The number of samples with voriconazole concentrations below 1 mg/l was significantly higher in patients who exhibited therapeutic failures (88% versus 27%; P < 0.001). In addition, the period of time in which voriconazole concentrations were maintained below 1 mg/l was slightly higher in patients in the failure group. We suggest that serum concentration should be individually quantified for patients receiving voriconazole therapy. Further prospective studies are needed to clarify the potential benefit of the individualization of treatment.
ISSN:1369-3786
1460-2709
DOI:10.3109/13693786.2011.630039