title: Therapeutic drug monitoring for triazoles: A needs assessment review and recommendations from a Canadian perspective.
abstract: Invasive fungal infections cause significant morbidity and mortality in patients with concomitant underlying immunosuppressive diseases. The recent addition of new triazoles to the antifungal armamentarium has allowed for extended-spectrum activity and flexibility of administration. Over the years, clinical use has raised concerns about the degree of drug exposure following standard approved drug dosing, questioning the need for therapeutic drug monitoring (TDM). Accordingly, the present guidelines focus on TDM of triazole antifungal agents. A review of the rationale for triazole TDM, the targeted patient populations and available laboratory methods, as well as practical recommendations based on current evidence from an extended literature review are provided in the present document.
authors.affiliation: Department of Microbiology and Infectious Diseases, Hôpital Maisonneuve-Rosemont, Montreal, Quebec;
authors.forename: Michel
authors.initials: M
authors.lastname: Laverdiere
authors.affiliation: Departments of Medical Microbiology and Infectious Diseases, and Internal Medicine, Sections of Infectious Diseases and Hematology/Oncology, Blood and Marrow Transplant, University of Manitoba, Winnipeg, Manitoba;
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Bow
authors.affiliation: Division of Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario;
authors.forename: Coleman
authors.initials: C
authors.lastname: Rotstein
authors.affiliation: Service des Maladies Infectieuses, Département de Pédiatrie; ; Unité de Pharmacologie Clinique, CHU Ste-Justine, Montreal, Quebec;
authors.forename: Julie
authors.initials: J
authors.lastname: Autmizguine
authors.affiliation: Division of Haematology, University of British Columbia, Vancouver, British Columbia;
authors.forename: Raewyn
authors.initials: R
authors.lastname: Broady
authors.affiliation: Division of Infectious Diseases, University of Ottawa/Ottawa Hospital, Ottawa;
authors.forename: Gary
authors.initials: G
authors.lastname: Garber
authors.affiliation: Hamilton Health Sciences, McMaster University, Hamilton, Ontario;
authors.forename: Shariq
authors.initials: S
authors.lastname: Haider
authors.affiliation: Solid Organ Transplantation, Pharmaceutical Sciences Clinical Service Unit, Vancouver General Hospital, Vancouver, British Columbia;
authors.forename: Trana
authors.initials: T
authors.lastname: Hussaini
authors.affiliation: Division of Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario;
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.affiliation: Service de Maladies Infectieuses, Département de Pédiatrie, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec;
authors.forename: Philippe
authors.initials: P
authors.lastname: Ovetchkine
authors.affiliation: Department of Pharmacy, Princess Margaret Cancer Centre, University Health Network; ; Leslie Dan Faculty of Pharmacy University of Toronto, Toronto, Ontario;
authors.forename: Jack T
authors.initials: JT
authors.lastname: Seki
authors.affiliation: Unité de Pharmacologie Clinique, CHU Ste-Justine, Montreal, Quebec; ; Département de Pharmacologie, Université de Montréal, Montreal, Quebec.
authors.forename: Yves
authors.initials: Y
authors.lastname: Théorêt
keywords: Invasive fungal infection; Therapeutic drug monitoring; Triazole antifungal antibiotics