title: [Usefulness of monitoring plasma voriconazole concentration in patients with chronic necrotizing pulmonary aspergillosis].
abstract: We investigated the significance and the usefulness of monitoring plasma voriconazole levels in patients with chronic necrotizing pulmonary aspergillosis associated with underlying chronic respiratory diseases. The average trough level was 2.2 microg/ml and there was no correlation between trough levels and voriconazole doses. Orally administered drug showed no significant difference in trough or peak levels compared with parenteral injection. Six cases with visual adverse events had significantly higher nadirs compared to those without visual disturbance. All three cases who discontinued the drug due to liver dysfunction had plasma trough levels higher than 4.0 microg/ml. Those who failed to respond to the treatment had trough levels lower than 1.4 microg/ml or peak levels lower than 2.8 microg/ml, while some cases with plasma level lower than those levels responded well. Since plasma voriconazole level has a large inter-patient variability, drug monitoring may be beneficial to evaluate the drug efficacy and safety in each individual.
authors.affiliation: Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.
authors.forename: Eri
authors.initials: E
authors.lastname: Hagiwara
authors.forename: Jun
authors.initials: J
authors.lastname: Shiihara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsushima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Enomoto
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tagawa
authors.forename: Akimasa
authors.initials: A
authors.lastname: Sekine
authors.forename: Noriko
authors.initials: N
authors.lastname: Tsuchiya
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Baba
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinohara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Endo
authors.forename: Yoko
authors.initials: Y
authors.lastname: Sogo
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishihira
authors.forename: Shigeru
authors.initials: S
authors.lastname: Komatsu
authors.forename: Terufumi
authors.initials: T
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Ogura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000188:drug therapy*; D011743:Pyrimidines / Q000008:administration & dosage / Q000097:blood*; D014230:Triazoles / Q000008:administration & dosage / Q000097:blood*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole