Voriconazole plasma levels in children are highly variable
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Voriconazole is widely used as first-line agent to treat invasive aspergillosis in immunocompromised adults. Also in children, its use is increasing . During the last decade, several studies in adults demonstrated a pharmacodynamic relationship between low voriconazole levels and lack of response, and high voriconazole levels and toxicity [2, 3]. However, voriconazole has very complex pharmacokinetics resulting in highly variable plasma levels. As a result, it is recommended to monitor voriconazole plasma levels in adult patients with uncontrolled infection, gastro-intestinal dysfunction, severe hepatic dysfunction, and unexplained neurological symptoms. Target trough levels should be higher than 1 or 2 mg/L to guarantee efficacy and lower than 6 mg/L to avoid toxicity [2, 3].
The relationship between voriconazole plasma concentrations and outcome has only been studied in adult patients . To our knowledge, until recently, only two studies were available on...
KeywordsOmeprazole Voriconazole Invasive Aspergillosis Trough Level Allergic Bronchopulmonary Aspergillosis
None to declare.
- 3.Andes D, Pascual A, Marchetti O (2009) Antifungal therapeutic drug monitoring: established and emerging indications. Antimicrob Agents Chemother 53:23–34Google Scholar
- 7.Van der Linden JWM, Bruggeman RJM, Knoop J et al (2009) Therapeutic drug monitoring of voriconazole in pediatric patients. Mycoses 52(Suppl 1):23Google Scholar
- 11.Vfend EMEA, European Assessment Report. Available from: http://www.ema.europa.eu/humandocs/PDFs/EPAR/vfend/404901en8.pdf. Accessed 29 January 2010