Back to Search
Start Over
Pharmacokinetic and Pharmacodynamic Properties of Oral Voriconazole in Patients with Invasive Fungal Infections.
- Source :
- Pharmacotherapy; Sep2015, Vol. 35 Issue 9, p797-804, 8p
- Publication Year :
- 2015
-
Abstract
- Study Objectives To assess the pharmacokinetic and pharmacodynamic ( PK/ PD) properties of voriconazole and to investigate the relationship between PK/ PD parameters and the efficacy of a fixed-dose oral regimen in the treatment of invasive fungal infections ( IFIs). Design Prospective and observational PK/ PD study. Setting A university-affiliated medical center. Patients Fifteen hospitalized patients with proven IFIs who were treated with oral voriconazole for at least 2 weeks. Methods We investigated the PK/ PD properties of voriconazole using a noncompartmental analysis in 15 patients. Results Marked interpatient variation in voriconazole pharmacokinetic properties was noted including peak plasma concentrations (median 2.31 mg/L, range 1.06-4.01 mg/L), 12-hour area under the plasma concentration-time curve ( AUC<subscript>τ</subscript>) (median 21.18 hr mg/L, range 7.71-42.07 hr mg/L), ratio of the unbound drug AUC over 24 hours ( fAUC<subscript>24</subscript>) divided by the minimum inhibitory concentration ( fAUC<subscript>24</subscript>: MIC; median 62.61, range 6.48-415.30), and the free trough plasma concentration (C<subscript>min</subscript>) divided by the MIC ( fC<subscript>min</subscript>: MIC; median 1.81, range 0.46-15.52). There was a good correlation between voriconazole C<subscript>min</subscript> and AUC<subscript>τ</subscript> ( R<superscript>2</superscript> = 0.805). Voriconazole therapy was effective in 66.7% of patients (10/15). No significant difference was observed with regard to successful clinical response between the patients with a fAUC<subscript>24</subscript>: MIC and fC<subscript>min</subscript>: MIC values higher than 25 and higher than 1 (10/12 vs 10/13, respectively; χ<superscript>2</superscript> = 1.61, p=0.688). Conclusion There is substantial interpatient variability in the PK/ PD properties of voriconazole. fAUC<subscript>24</subscript>: MIC values higher than 25 and fC<subscript>min</subscript>: MIC values higher than 1 may predict clinical response in patients with IFIs. Designing an optimal dosage regimen based on individual PK/ PD properties will improve the efficacy in patients with IFIs. [ABSTRACT FROM AUTHOR]
- Subjects :
- PHARMACOKINETICS
PHARMACODYNAMICS
MYCOSES
VORICONAZOLE
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 02770008
- Volume :
- 35
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Pharmacotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 109968830
- Full Text :
- https://doi.org/10.1002/phar.1631