title: Therapeutic drug monitoring of voriconazole and posaconazole.
abstract: Despite the availability of newer antifungal agents, invasive fungal diseases remain a leading cause of morbidity and mortality in immunocompromised patients. Voriconazole and posaconazole are two extended-spectrum triazoles indicated for treatment and prophylaxis of invasive fungal diseases. Recently, there has been increased interest in the utility of therapeutic drug monitoring to optimize safety and efficacy of antifungals in an attempt to improve patient outcomes. We reviewed the pharmacokinetic and pharmacodynamic characteristics of voriconazole and posaconazole in the context of clinical indications for therapeutic drug monitoring. In addition, the most recent evidence examining the relationship between serum concentrations of voriconazole and posaconazole and their efficacy or toxicities was evaluated. This information was then integrated to formulate recommendations for use of therapeutic drug monitoring in clinical settings.
authors.affiliation: Department of Pharmacy, Vancouver General Hospital, Vancouver, British Columbia, Canada.
authors.forename: Trana
authors.initials: T
authors.lastname: Hussaini
authors.forename: Maria J G T
authors.initials: MJ
authors.lastname: Rüping
authors.forename: Fedja
authors.initials: F
authors.lastname: Farowski
authors.forename: Janne J
authors.initials: JJ
authors.lastname: Vehreschild
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Cornely
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D011743:Pyrimidines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology; D014230:Triazoles / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C101425:posaconazole; D065819:Voriconazole