Effects of antifungal stewardship using therapeutic drug monitoring in voriconazole therapy on the prevention and control of hepatotoxicity and visual symptoms: A multicentre study conducted in Japan.

Mycoses
Yukihiro HamadaYoshio Takesue

Abstract

Hepatotoxicity and visual symptoms are common adverse effects (AEs) of voriconazole therapy. To retrospectively evaluate the effects of treatment modification based on therapeutic drug monitoring on AEs in patients undergoing voriconazole therapy. The target voriconazole trough concentration (Cmin ) was 1-5 µg/mL. Receiver operating characteristic curves were used to determine Cmin cut-offs for AEs. A total of 401 patients were included. Among 108 patients with high initial Cmin , voriconazole was discontinued in 32 and the dose was reduced in 71. Among 44 patients with low initial Cmin , voriconazole was discontinued in 4 and the dose was increased in 19. Hepatotoxicity occurred in 6.0% of patients, after a median of 10 days. Visual symptoms were evident in 9.5% of patients after a median of 4 days. Initial Cmin was significantly associated with visual symptoms but not hepatotoxicity, which suggested the effect of treatment modification on hepatotoxicity. However, both hepatotoxicity and visual symptoms were significantly correlated with Cmin at the onset of AEs, and the Cmin cut-offs were 3.5 μg/mL for hepatotoxicity and 4.2 μg/mL for visual symptoms. Voriconazole was discontinued after the occurrence of AEs in 62.5% of patie...Continue Reading

References

Jun 19, 1998·Therapeutic Drug Monitoring·M KimuraS Higuchi
Dec 4, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·S AsciogluUNKNOWN Mycoses Study Group of the National Institute of Allergy and Infectious Diseases
Jan 25, 2002·The New England Journal of Medicine·Thomas J WalshUNKNOWN National Institute of Allergy and Infectious Diseases Mycoses Study Group
Jul 18, 2002·Antimicrobial Agents and Chemotherapy·L PurkinsD Kleinermans
Feb 21, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Leonard B Johnson, Carol A Kauffman
Jun 5, 2004·Clinical Pharmacology and Therapeutics·Yasuhiko IkedaMitsuyoshi Nakashima
Oct 16, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Aileen E BoydDavid W Denning
Jun 29, 2006·Clinical Pharmacokinetics·Ursula TheuretzbacherHartmut Derendorf
Jan 4, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andres PascualOscar Marchetti
Jan 8, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas J WalshUNKNOWN Infectious Diseases Society of America
May 22, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Dimitrios I ZoniosJohn E Bennett
Oct 29, 2008·Antimicrobial Agents and Chemotherapy·David AndesOscar Marchetti
Mar 6, 2009·International Journal of Antimicrobial Agents·Kazuaki MatsumotoKatsushi Yamada
Dec 3, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Michael NeelyJill Hoffman
Jul 20, 2011·Antimicrobial Agents and Chemotherapy·Peter F TrokeWilliam W Hope
Apr 11, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M-L LuongS Husain
Jul 4, 2012·Antimicrobial Agents and Chemotherapy·Michael J DoltonAndrew J McLachlan
Jul 5, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Wan Beom ParkKyung-Sang Yu
Sep 8, 2012·Infection·T SaitoUNKNOWN NHO Pulmonary Fungosis Research Group
Jan 4, 2013·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M Cuenca-EstrellaUNKNOWN ESCMID Fungal Infection Study Group
Jan 4, 2013·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A J UllmannUNKNOWN ESCMID Fungal Infection Study Group
May 16, 2013·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Yukihiro HamadaYoshio Takesue
Dec 25, 2015·The European Respiratory Journal·David W DenningUNKNOWN European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
Taotao WangYalin Dong
American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
M-L LuongS Husain
Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
I AmiguesGenovefa A Papanicolaou
© 2022 Meta ULC. All rights reserved