Voriconazole drug monitoring in the management of invasive fungal infection in immunocompromised children: a prospective study

Objectives To evaluate voriconazole plasma level monitoring in immunocompromised children and determine the relationship of plasma levels with dose, safety and efficacy. Methods We used a prospective study including all consecutive children with invasive fungal infection (IFI) treated with voriconaz...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2012-03, Vol.67 (3), p.700-706
Main Authors: Soler-Palacín, Pere, Frick, Marie Antoinette, Martín-Nalda, Andrea, Lanaspa, Miguel, Pou, Leonor, Roselló, Eva, Diaz de Heredia, Cristina, Figueras, Concepció
Format: Article
Language:English
Subjects:
Adolescent
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal Agents - administration & dosage
Antifungal Agents - adverse effects
Antifungal Agents - pharmacokinetics
Biological and medical sciences
Child
Child, Preschool
Children & youth
Correlation analysis
Drug dosages
Drug Monitoring - methods
Drug-Related Side Effects and Adverse Reactions - epidemiology
Female
Fungal infections
Human mycoses
Humans
Immunocompromised Host
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Incidence
Infant
Infectious diseases
Male
Medical sciences
Miscellaneous mycoses
Mycoses
Mycoses - drug therapy
Pharmacology. Drug treatments
Plasma
Plasma - chemistry
Prospective Studies
Pyrimidines - administration & dosage
Pyrimidines - adverse effects
Pyrimidines - pharmacokinetics
Treatment Outcome
Triazoles - administration & dosage
Triazoles - adverse effects
Triazoles - pharmacokinetics
Voriconazole
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Summary:Objectives To evaluate voriconazole plasma level monitoring in immunocompromised children and determine the relationship of plasma levels with dose, safety and efficacy. Methods We used a prospective study including all consecutive children with invasive fungal infection (IFI) treated with voriconazole between August 2008 and May 2010. IFI diagnosis and clinical outcome evaluation were based on European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group ('EORTC/MSG') definitions. Results A total of 196 voriconazole plasma trough measurements from 30 patients (median age 10 years) obtained during 2135 days of voriconazole therapy were analysed. Nineteen patients (63%) presented with proven or probable IFI. Voriconazole plasma levels varied widely and 73% of patients required dose adjustment. The median voriconazole dose was 20 mg/kg/day and the median duration of therapy was 6 weeks. Age 5 was the smallest value defining two groups on which the correlation between dose and plasma levels had a different behaviour, and this relationship was especially significant for patients
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkr517