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Pharmacodynamic studies of voriconazole: informing the clinical management of invasive fungal infections.
- Source :
-
Expert review of anti-infective therapy [Expert Rev Anti Infect Ther] 2016 Aug; Vol. 14 (8), pp. 731-46. - Publication Year :
- 2016
-
Abstract
- Introduction: Voriconazole is a broad-spectrum antifungal agent commonly used to treat invasive fungal infections (IFI), including aspergillosis, candidiasis, Scedosporium infection, and Fusarium infection. IFI often occur in immunocompromised patients, leading to increased morbidity and mortality.<br />Areas Covered: The objective of this review is to summarize the pharmacodynamic properties of voriconazole and to provide considerations for potential optimal dosing strategies. Studies have demonstrated superior clinical response when an AUC/MIC >25 or Cmin/MIC >1 is attained in adult patients, correlating to a trough concentration range as narrow as 2-4.5 mg/L; however, these targets are poorly established in the pediatric population. Topics in this discussion include voriconazole use in multiple age groups, predisposing patient factors for IFI, and considerations for clinicians managing IFI. Expert commentary: The relationship between voriconazole dosing and exposure is not well defined due to the large inter- and intra-subject variability. Development of comprehensive decision support tools for individualizing dosing, particularly in children who require higher dosing, will help to increase the probability of achieving therapeutic efficacy and decrease sub-therapeutic dosing and adverse events.
- Subjects :
- Antifungal Agents administration & dosage
Antifungal Agents pharmacokinetics
Antifungal Agents pharmacology
Area Under Curve
Dose-Response Relationship, Drug
Genetic Predisposition to Disease
Humans
Invasive Fungal Infections genetics
Invasive Fungal Infections immunology
Invasive Fungal Infections microbiology
Microbial Sensitivity Tests
Models, Biological
Voriconazole administration & dosage
Voriconazole pharmacokinetics
Voriconazole pharmacology
Antifungal Agents therapeutic use
Invasive Fungal Infections drug therapy
Voriconazole therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1744-8336
- Volume :
- 14
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Expert review of anti-infective therapy
- Publication Type :
- Academic Journal
- Accession number :
- 27355512
- Full Text :
- https://doi.org/10.1080/14787210.2016.1207526