Voriconazole in clinical practice

Maurizio Sanguinetti, Malgorzata Karolina Mikulska, Małgorzata Mikulska, Andrea Novelli, Franco Aversa, Simone Cesaro, Francesco Giuseppe De Rosa, Corrado Girmenia, Alessandra Micozzi, Claudio Viscoli

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

47 Citazioni (Scopus)

Abstract

Invasive fungal diseases are associated with significant morbidity and mortality in immunocompromized patients. Voriconazole is the first line treatment of invasive aspergillosis, and has been successfully used in other invasive fungal infections, such as candidiasis, fusariosis or scedosporidiosis. Voriconazole has non-linear pharmacokinetics and undergoes extensive hepatic metabolism by the cytochrome P450 system that depends on age, genetic factors, and interactions with other drugs. Thus, significant interpatient variability is observed after administration of the same dose. Additionally, the therapeutic window is narrow, with high risk of side effects at serum levels 3-5 times higher than the minimal threshold for efficacy. Therefore, the knowledge of pharmacological properties, metabolism, interactions, dosage indications in various populations and side effects is crucial. Therapeutic drug monitoring can help maximize the efficacy and minimize the risk of toxicity. Pharmacological, mycological and clinical aspects of the treatment with voriconazole are summarized in order to optimize its use in daily clinical practice.
Lingua originaleEnglish
pagine (da-a)311-327
Numero di pagine17
RivistaJournal of Chemotherapy
Volume24
DOI
Stato di pubblicazionePubblicato - 2012

Keywords

  • Voriconazole

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