Therapeutic drug monitoring for triazoles.
OBJECTIVE
Invasive fungal infections are a leading cause of morbidity and mortality in immunocompromised patients, and mechanisms to optimize therapeutic outcomes are urgently required. Therapeutic drug monitoring represents an important component for the routine use of the triazoles.


RESULTS
Triazoles have revolutionized the prevention and treatment of invasive fungal infections. Increasing data suggest that this class displays important concentration-effect and concentration-toxicity relationships. There has been an increased understanding of the pharmacokinetics and pharmacodynamics of triazoles, and this has facilitated the identification of concentrations (or drug exposures) that are both effective and nontoxic. This review discusses the application of therapeutic drug monitoring to fluconazole, itraconazole, voriconazole and posaconazole.


CONCLUSIONS
Therapeutic drug monitoring represents an important mechanism to optimize the outcome of immunocompromised patients receiving triazoles.
Hope
William W
WW
School of Translational Medicine, The University of Manchester, Manchester, UK. william.hope@manchester.ac.uk
Billaud
Eliane M
EM
Lestner
Jodie
J
Denning
David W
DW
D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*; D014230:Triazoles / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use
D000935:Antifungal Agents; D014230:Triazoles