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.

Mikulska, M. K., Novelli, A., Aversa, F., Cesaro, S., De Rosa, F., Girmenia, C., Micozzi, A., Sanguinetti, M., Viscoli, C., Voriconazole in clinical practice, <<JOURNAL OF CHEMOTHERAPY>>, 2012; 24 (6): 311-327. [doi:10.1179/1973947812Y.0000000051] [http://hdl.handle.net/10807/39477]

Voriconazole in clinical practice

Mikulska, Malgorzata Karolina;Sanguinetti, Maurizio;
2012

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.
2012
Inglese
Mikulska, M. K., Novelli, A., Aversa, F., Cesaro, S., De Rosa, F., Girmenia, C., Micozzi, A., Sanguinetti, M., Viscoli, C., Voriconazole in clinical practice, <<JOURNAL OF CHEMOTHERAPY>>, 2012; 24 (6): 311-327. [doi:10.1179/1973947812Y.0000000051] [http://hdl.handle.net/10807/39477]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/39477
Citazioni
  • ???jsp.display-item.citation.pmc??? 15
  • Scopus 61
  • ???jsp.display-item.citation.isi??? 45
social impact