title: Inhibition of voriconazole metabolism by chloramphenicol in an adolescent with central nervous system aspergillosis.
abstract: For an adolescent with bacterial meningitis and subsequent cerebral aspergillosis, intravenous voriconazole dose requirements substantially decreased during coadministration with intravenous chloramphenicol and considerably rose after discontinuation of the antibiotic. In agreement with in vitro evidence, these data suggest that chloramphenicol is a rather significant inhibitor of hepatic CYP3A4 and/or CYP2C19.
authors.affiliation: Department of Internal Medicine VI, Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Hafner
authors.forename: Nadine
authors.initials: N
authors.lastname: Albermann
authors.forename: Walter E
authors.initials: WE
authors.lastname: Haefeli
authors.forename: Friedrich
authors.initials: F
authors.lastname: Ebinger
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000378:metabolism*; D001189:Aryl Hydrocarbon Hydroxylases / Q000037:antagonists & inhibitors; D002701:Chloramphenicol / Q000008:administration & dosage / Q000009:adverse effects*; D065731:Cytochrome P-450 CYP2C19; D051544:Cytochrome P-450 CYP3A; D065692:Cytochrome P-450 CYP3A Inhibitors; D004347:Drug Interactions; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D020953:Neuroaspergillosis / Q000188:drug therapy* / Q000378:metabolism*; D011743:Pyrimidines / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*; D014230:Triazoles / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*; D065819:Voriconazole
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D065692:Cytochrome P-450 CYP3A Inhibitors; D004791:Enzyme Inhibitors; D011743:Pyrimidines; D014230:Triazoles; D002701:Chloramphenicol; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D065819:Voriconazole
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