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Published in: Current Fungal Infection Reports 2/2011

01-06-2011

Update on Antifungal Drug Dosing and Therapeutic Drug Monitoring

Author: Steven Trifilio

Published in: Current Fungal Infection Reports | Issue 2/2011

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Abstract

The prevention and treatment of invasive fungal infections can be compromised by antifungal agents that display unpredictable pharmacokinetics and significant drug interactions and which demonstrate a strong relationship between drug exposure and efficacy and toxicity. Clinical studies have shown that maintaining antifungal drug levels within a targeted range decreases the risk for treatment failure and drug toxicity and thus have established a role for therapeutic drug monitoring with the use of various agents. Evidence from experimental and clinical studies supporting the role of therapeutic drug monitoring and practical applications for attaining targeted levels are reviewed.
Literature
1.
go back to reference Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis. 2010;50(8):1101–11.PubMedCrossRef Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis. 2010;50(8):1101–11.PubMedCrossRef
2.
go back to reference Person AK, Kontoyiannis DP, Alexander BD, et al. Fungal infections in transplant and oncology patients. Infect Dis Clin North Am. 2010;24(2):439–59.PubMedCrossRef Person AK, Kontoyiannis DP, Alexander BD, et al. Fungal infections in transplant and oncology patients. Infect Dis Clin North Am. 2010;24(2):439–59.PubMedCrossRef
3.
go back to reference Marr KA. Fungal infections in oncology patients: update on epidemiology, prevention, and treatment. Curr Opin Oncol. 2010;22(2):138–42.PubMedCrossRef Marr KA. Fungal infections in oncology patients: update on epidemiology, prevention, and treatment. Curr Opin Oncol. 2010;22(2):138–42.PubMedCrossRef
4.
go back to reference Kontoyiannis DP, Marr KA, Park BJ, Alexander BD, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010;50(8):1091–100.PubMedCrossRef Kontoyiannis DP, Marr KA, Park BJ, Alexander BD, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010;50(8):1091–100.PubMedCrossRef
5.
go back to reference Hachem R, Hanna H, Kontoyiannis D, et al. The changing epidemiology of invasive candidiasis: Candida glabrata and Candida krusei as the leading causes of candidemia in hematologic malignancy. Cancer. 2008;112:2493–9.PubMedCrossRef Hachem R, Hanna H, Kontoyiannis D, et al. The changing epidemiology of invasive candidiasis: Candida glabrata and Candida krusei as the leading causes of candidemia in hematologic malignancy. Cancer. 2008;112:2493–9.PubMedCrossRef
6.
7.
go back to reference • Kontoyiannis DP. Antifungal prophylaxis in hematopoietic stem cell transplant recipients: The unfinished tale of imperfect success. Bone Marrow Transplant. 2011;46(2):165–73. This article presents an insightful perspective on antifungal prophylaxis based upon risk stratification. Established antifungal prophylaxis guidelines, limitations, newly identified metabolic and genetic risk factors, and future directions are discussed. PubMedCrossRef • Kontoyiannis DP. Antifungal prophylaxis in hematopoietic stem cell transplant recipients: The unfinished tale of imperfect success. Bone Marrow Transplant. 2011;46(2):165–73. This article presents an insightful perspective on antifungal prophylaxis based upon risk stratification. Established antifungal prophylaxis guidelines, limitations, newly identified metabolic and genetic risk factors, and future directions are discussed. PubMedCrossRef
8.
go back to reference Wirk B, Wingard JR. Current approaches in antifungal prophylaxis in high risk hematologic malignancy and hematopoietic stem cell transplant patients. Mycopathologia. 2009;168(6):299–311.PubMedCrossRef Wirk B, Wingard JR. Current approaches in antifungal prophylaxis in high risk hematologic malignancy and hematopoietic stem cell transplant patients. Mycopathologia. 2009;168(6):299–311.PubMedCrossRef
9.
go back to reference Decosterd LA, Rochat B, Pesse B, et al. Multiplex ultra-performance liquid chromatography-tandem mass spectrometry method for simultaneous quantification in human plasma of fluconazole, itraconazole, hydroxyitraconazole, posaconazole, voriconazole, voriconazole-N-oxide, anidulafungin, and caspofungin. Antimicrob Agents Chemother. 2010;54(12):5303–15.PubMedCrossRef Decosterd LA, Rochat B, Pesse B, et al. Multiplex ultra-performance liquid chromatography-tandem mass spectrometry method for simultaneous quantification in human plasma of fluconazole, itraconazole, hydroxyitraconazole, posaconazole, voriconazole, voriconazole-N-oxide, anidulafungin, and caspofungin. Antimicrob Agents Chemother. 2010;54(12):5303–15.PubMedCrossRef
10.
go back to reference Law D, Moore CB, Denning DW. Discrepancies associated with the measurement of itraconazole serum concentrations by bioassays. J Antimicrob Chemother. 1999;44(4):577–8.PubMedCrossRef Law D, Moore CB, Denning DW. Discrepancies associated with the measurement of itraconazole serum concentrations by bioassays. J Antimicrob Chemother. 1999;44(4):577–8.PubMedCrossRef
11.
go back to reference Morrell M, Fraser VJ, Kollef MH. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother. 2005;49:3640–5.PubMedCrossRef Morrell M, Fraser VJ, Kollef MH. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother. 2005;49:3640–5.PubMedCrossRef
12.
go back to reference Hope WW, Petraitis V, Petraitiene R, et al. The initial 96 hours of invasive pulmonary aspergillosis: histopathology, comparative kinetics of galactomannan and (1- >3) β-d-glucan and consequences of delayed antifungal therapy. Antimicrob Agents Chemother. 2010;54(11):4879–86.PubMedCrossRef Hope WW, Petraitis V, Petraitiene R, et al. The initial 96 hours of invasive pulmonary aspergillosis: histopathology, comparative kinetics of galactomannan and (1- >3) β-d-glucan and consequences of delayed antifungal therapy. Antimicrob Agents Chemother. 2010;54(11):4879–86.PubMedCrossRef
13.
go back to reference • Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008;47(4):503–9. Collectively, references [10] through [13] identify delay in antifungal drug therapy as a risk factor for treatment failure and increased mortality. PubMedCrossRef • Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008;47(4):503–9. Collectively, references [10] through [13] identify delay in antifungal drug therapy as a risk factor for treatment failure and increased mortality. PubMedCrossRef
14.
go back to reference Miyakis S, van Hal SJ, Solvag CJ, et al. Clinician ordering practices for voriconazole therapeutic drug monitoring: experiences of a referral laboratory. Ther Drug Monit. 2010;32(5):661–5.PubMedCrossRef Miyakis S, van Hal SJ, Solvag CJ, et al. Clinician ordering practices for voriconazole therapeutic drug monitoring: experiences of a referral laboratory. Ther Drug Monit. 2010;32(5):661–5.PubMedCrossRef
15.
go back to reference Andes D, Safdar N, Marchillo K, et al. Pharmacokinetic-pharmacodynamic comparison of amphotericin B (AMB) and two lipid-associated AMB preparations, liposomal AMB and AMB lipid complex, in murine candidiasis models. Antimicrob Agents Chemother. 2006;50(2):674–84.PubMedCrossRef Andes D, Safdar N, Marchillo K, et al. Pharmacokinetic-pharmacodynamic comparison of amphotericin B (AMB) and two lipid-associated AMB preparations, liposomal AMB and AMB lipid complex, in murine candidiasis models. Antimicrob Agents Chemother. 2006;50(2):674–84.PubMedCrossRef
16.
go back to reference Lewis RE, Liao G, Hou J, et al. Comparative analysis of amphotericin B lipid complex and liposomal amphotericin B kinetics of lung accumulation and fungal clearance in a murine model of acute invasive pulmonary aspergillosis. Antimicrob Agents Chemother. 2006;50(2):674–84.CrossRef Lewis RE, Liao G, Hou J, et al. Comparative analysis of amphotericin B lipid complex and liposomal amphotericin B kinetics of lung accumulation and fungal clearance in a murine model of acute invasive pulmonary aspergillosis. Antimicrob Agents Chemother. 2006;50(2):674–84.CrossRef
17.
go back to reference Lestner JM, Howard SJ, Goodwin J, et al. Pharmacokinetics and pharmacodynamics of amphotericin B deoxycholate, liposomal amphotericin B, and amphotericin B lipid complex in an in vitro model of invasive pulmonary aspergillosis. Antimicrob Agents Chemother. 2010;54(8):3432–41.PubMedCrossRef Lestner JM, Howard SJ, Goodwin J, et al. Pharmacokinetics and pharmacodynamics of amphotericin B deoxycholate, liposomal amphotericin B, and amphotericin B lipid complex in an in vitro model of invasive pulmonary aspergillosis. Antimicrob Agents Chemother. 2010;54(8):3432–41.PubMedCrossRef
18.
go back to reference Lewis RE, Albert ND, Liao G, et al. Comparative pharmacodynamics of amphotericin B lipid complex and liposomal amphotericin B in a murine model of pulmonary mucormycosis. Antimicrob Agents Chemother. 2010;54(3):1298–304.PubMedCrossRef Lewis RE, Albert ND, Liao G, et al. Comparative pharmacodynamics of amphotericin B lipid complex and liposomal amphotericin B in a murine model of pulmonary mucormycosis. Antimicrob Agents Chemother. 2010;54(3):1298–304.PubMedCrossRef
19.
go back to reference Cornely OA, Maertens J, Bresnik M, et al. Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin Infect Dis. 2007;44(10):1289–97.PubMedCrossRef Cornely OA, Maertens J, Bresnik M, et al. Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin Infect Dis. 2007;44(10):1289–97.PubMedCrossRef
20.
go back to reference Eriksson U, Seifert B, Schaffner A. Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: randomised controlled trial. BMJ. 2001;322(7286):579–82.PubMedCrossRef Eriksson U, Seifert B, Schaffner A. Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: randomised controlled trial. BMJ. 2001;322(7286):579–82.PubMedCrossRef
21.
go back to reference Cutler RE, Blair AD, Kelly MR. Flucytosine kinetics in subjects with normal and impaired renal function. Clin Pharmacol Ther. 1978;24(3):333–42.PubMed Cutler RE, Blair AD, Kelly MR. Flucytosine kinetics in subjects with normal and impaired renal function. Clin Pharmacol Ther. 1978;24(3):333–42.PubMed
22.
go back to reference Vermes A. An in vitro study on the active conversion of flucytosine to fluorouracil by microorganisms in the human intestinal microflora. Chemotherapy. 2003;49(1–2):17–23.PubMedCrossRef Vermes A. An in vitro study on the active conversion of flucytosine to fluorouracil by microorganisms in the human intestinal microflora. Chemotherapy. 2003;49(1–2):17–23.PubMedCrossRef
23.
go back to reference Andes D, van Ogtrop M. In vivo characterization of the pharmacodynamics of flucytosine in a neutropenic murine disseminated candidiasis model. Antimicrob Agents Chemother. 2000;44:938–42.PubMedCrossRef Andes D, van Ogtrop M. In vivo characterization of the pharmacodynamics of flucytosine in a neutropenic murine disseminated candidiasis model. Antimicrob Agents Chemother. 2000;44:938–42.PubMedCrossRef
24.
go back to reference Stamm A, Diasio A, Dismukes R, et al. Toxicity of amphotericin B plus flucytosine in 194 patients with cryptococcal meningitis. Am J Med. 1987;83:236–42.PubMedCrossRef Stamm A, Diasio A, Dismukes R, et al. Toxicity of amphotericin B plus flucytosine in 194 patients with cryptococcal meningitis. Am J Med. 1987;83:236–42.PubMedCrossRef
25.
go back to reference Francis P, Walsh TJ. Evolving role of flucytosine in immunocompromised patients: new insights into safety, pharmacokinetics, and antifungal therapy. Clin Infect Dis. 1992;15(6):1003–18.PubMedCrossRef Francis P, Walsh TJ. Evolving role of flucytosine in immunocompromised patients: new insights into safety, pharmacokinetics, and antifungal therapy. Clin Infect Dis. 1992;15(6):1003–18.PubMedCrossRef
26.
go back to reference Hope W, Warn PA, Sharp A, et al. Derivation of an in vivo drug exposure breakpoint for flucytosine against Candida albicans and impact of the MIC, growth rate, and resistance genotype on the antifungal effect. Antimicrob Agents Chemother. 2006;50(11):3680–8.PubMedCrossRef Hope W, Warn PA, Sharp A, et al. Derivation of an in vivo drug exposure breakpoint for flucytosine against Candida albicans and impact of the MIC, growth rate, and resistance genotype on the antifungal effect. Antimicrob Agents Chemother. 2006;50(11):3680–8.PubMedCrossRef
27.
go back to reference Perfect J, Dismukes W, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(3):291–322.PubMedCrossRef Perfect J, Dismukes W, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(3):291–322.PubMedCrossRef
28.
go back to reference Pappas G, Kauffman C, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:503–35.PubMedCrossRef Pappas G, Kauffman C, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:503–35.PubMedCrossRef
29.
go back to reference Pasqualotto A, Howard S, Moore C, Denning DW. Flucytosine therapeutic monitoring: 15 years experience from the UK. J Antimicrob Chemother. 2007;59:791–3.PubMedCrossRef Pasqualotto A, Howard S, Moore C, Denning DW. Flucytosine therapeutic monitoring: 15 years experience from the UK. J Antimicrob Chemother. 2007;59:791–3.PubMedCrossRef
30.
go back to reference Manjunath P, Pai M, Bruce H, et al. Clinical pharmacokinetics of oral controlled-release 5-fluorocytosine. Antimicrob Agents Chemother. 2010;54(3):1237–41.CrossRef Manjunath P, Pai M, Bruce H, et al. Clinical pharmacokinetics of oral controlled-release 5-fluorocytosine. Antimicrob Agents Chemother. 2010;54(3):1237–41.CrossRef
31.
go back to reference Andes D, van Ogtrop M. Characterization and quantitation of the pharmacodynamics of fluconazole in a neutropenic murine disseminated candidiasis infection model. Antimicrob Agents Chemother. 1999;43(9):2116–20.PubMed Andes D, van Ogtrop M. Characterization and quantitation of the pharmacodynamics of fluconazole in a neutropenic murine disseminated candidiasis infection model. Antimicrob Agents Chemother. 1999;43(9):2116–20.PubMed
32.
go back to reference Andes D, Marchillo K, Stamstad T, et al. In vivo pharmacokinetics and pharmacodynamics of a new triazole, voriconazole, in a murine candidiasis model. Antimicrob Agents Chemother. 2003;47(10):3165–9.PubMedCrossRef Andes D, Marchillo K, Stamstad T, et al. In vivo pharmacokinetics and pharmacodynamics of a new triazole, voriconazole, in a murine candidiasis model. Antimicrob Agents Chemother. 2003;47(10):3165–9.PubMedCrossRef
33.
go back to reference Andes D, Marchillo K, Conklin R, Krishna G, et al. Pharmacodynamics of a new triazole, posaconazole, in a murine model of disseminated candidiasis D. Antimicrob Agents Chemother. 2004;48(1):137–42.PubMedCrossRef Andes D, Marchillo K, Conklin R, Krishna G, et al. Pharmacodynamics of a new triazole, posaconazole, in a murine model of disseminated candidiasis D. Antimicrob Agents Chemother. 2004;48(1):137–42.PubMedCrossRef
34.
go back to reference Bartel A, Phatak A, Horn K, et al. Drug interactions involving antifungal drugs: time course and clinical significance. Curr Fungal Infect Rep. 2010;4:103–10.CrossRef Bartel A, Phatak A, Horn K, et al. Drug interactions involving antifungal drugs: time course and clinical significance. Curr Fungal Infect Rep. 2010;4:103–10.CrossRef
35.
go back to reference Te Loo DM. Effect of azole antifungal therapy on vincristine toxicity in childhood acute lymphoblastic leukemia [abstract]. American Society of Clinical Oncology (ASCO) Annual Meeting. Abstract 10049. Te Loo DM. Effect of azole antifungal therapy on vincristine toxicity in childhood acute lymphoblastic leukemia [abstract]. American Society of Clinical Oncology (ASCO) Annual Meeting. Abstract 10049.
36.
go back to reference Sathiapalan RK, El-Solh H. Enhanced vincristine neurotoxicity from drug interactions: case report and review of literature. Pediatr Hematol Oncol. 2001;18(8):543–6.PubMedCrossRef Sathiapalan RK, El-Solh H. Enhanced vincristine neurotoxicity from drug interactions: case report and review of literature. Pediatr Hematol Oncol. 2001;18(8):543–6.PubMedCrossRef
37.
go back to reference Porter CC, Carver AE, Albano EA. Vincristine induced peripheral neuropathy potentiated by voriconazole in a patient with previously undiagnosed CMT1X. Pediatr Blood Cancer. 2009;52(2):298–300.PubMedCrossRef Porter CC, Carver AE, Albano EA. Vincristine induced peripheral neuropathy potentiated by voriconazole in a patient with previously undiagnosed CMT1X. Pediatr Blood Cancer. 2009;52(2):298–300.PubMedCrossRef
38.
go back to reference Harnicar S, Adel N, Jurcic J. Modification of vincristine dosing during concomitant azole therapy in adult acute lymphoblastic leukemia patients. J Oncol Pharm Pract. 2009;15(3):175–82.PubMedCrossRef Harnicar S, Adel N, Jurcic J. Modification of vincristine dosing during concomitant azole therapy in adult acute lymphoblastic leukemia patients. J Oncol Pharm Pract. 2009;15(3):175–82.PubMedCrossRef
39.
go back to reference Eiden C, Palenzuela G, Hillaire-Buys D, et al. Posaconazole-increased vincristine neurotoxicity in a child: a case report. J Pediatr Hematol Oncol. 2009;31(4):292–5.PubMedCrossRef Eiden C, Palenzuela G, Hillaire-Buys D, et al. Posaconazole-increased vincristine neurotoxicity in a child: a case report. J Pediatr Hematol Oncol. 2009;31(4):292–5.PubMedCrossRef
40.
go back to reference Yamazaki H, Nakamoto M, Shimizu M, et al. Potential impact of cytochrome P450 3A5 in human liver on drug interactions with triazoles. Br J Clin Pharmacol. 2010;69(6):593–7.PubMedCrossRef Yamazaki H, Nakamoto M, Shimizu M, et al. Potential impact of cytochrome P450 3A5 in human liver on drug interactions with triazoles. Br J Clin Pharmacol. 2010;69(6):593–7.PubMedCrossRef
41.
go back to reference Pinto A, Chan RC. Lack of allergic cross-reactivity between fluconazole and voriconazole. Antimicrob Agents Chemother. 2009;53(4):1715–6.PubMedCrossRef Pinto A, Chan RC. Lack of allergic cross-reactivity between fluconazole and voriconazole. Antimicrob Agents Chemother. 2009;53(4):1715–6.PubMedCrossRef
42.
go back to reference Spellberg B, Rieg G, Bayer A, et al. Lack of cross-hepatotoxicity between fluconazole and voriconazole. Clin Infect Dis. 2003;36:1091–3.PubMedCrossRef Spellberg B, Rieg G, Bayer A, et al. Lack of cross-hepatotoxicity between fluconazole and voriconazole. Clin Infect Dis. 2003;36:1091–3.PubMedCrossRef
43.
go back to reference Rex JH, Pfaller MA, Galgiani JN, et al. Development of interpretive breakpoints for antifungal susceptibility testing: conceptual framework and analysis of in vitro-in vivo correlation data for fluconazole, itraconazole, and candida infections. Subcommittee on antifungal susceptibility testing of the National Committee for clinical laboratory standards. Clin Infect Dis. 1997;24(2):235–47.PubMedCrossRef Rex JH, Pfaller MA, Galgiani JN, et al. Development of interpretive breakpoints for antifungal susceptibility testing: conceptual framework and analysis of in vitro-in vivo correlation data for fluconazole, itraconazole, and candida infections. Subcommittee on antifungal susceptibility testing of the National Committee for clinical laboratory standards. Clin Infect Dis. 1997;24(2):235–47.PubMedCrossRef
44.
go back to reference Pai MP, Turpin RS, Garey KW. Association of fluconazole area under the concentration-time curve/MIC and dose/MIC ratios with mortality in nonneutropenic patients with candidemia. Antimicrob Agents Chemother. 2007;51(1):35–9.PubMedCrossRef Pai MP, Turpin RS, Garey KW. Association of fluconazole area under the concentration-time curve/MIC and dose/MIC ratios with mortality in nonneutropenic patients with candidemia. Antimicrob Agents Chemother. 2007;51(1):35–9.PubMedCrossRef
45.
go back to reference Baddley J, Patel M, Manjunath S, et al. Association of fluconazole pharmacodynamics with mortality in patients with candidemia. Antimicrob Agents Chemother. 2008;52(9):3022–8.PubMedCrossRef Baddley J, Patel M, Manjunath S, et al. Association of fluconazole pharmacodynamics with mortality in patients with candidemia. Antimicrob Agents Chemother. 2008;52(9):3022–8.PubMedCrossRef
46.
go back to reference Garey KW, Pai MP, Suda KJ, et al. Inadequacy of fluconazole dosing in patients with candidemia based on Infectious Diseases Society of America (IDSA) guidelines. Pharmacoepidemiol Drug Saf. 2007;16(8):919–27.PubMedCrossRef Garey KW, Pai MP, Suda KJ, et al. Inadequacy of fluconazole dosing in patients with candidemia based on Infectious Diseases Society of America (IDSA) guidelines. Pharmacoepidemiol Drug Saf. 2007;16(8):919–27.PubMedCrossRef
47.
go back to reference Barone JA, Koh JG, Bierman RH, et al. Food interaction and steady-state pharmacokinetics of itraconazole capsules in healthy male volunteers. Antimicrob Agents Chemother. 1993;37:778–84.PubMed Barone JA, Koh JG, Bierman RH, et al. Food interaction and steady-state pharmacokinetics of itraconazole capsules in healthy male volunteers. Antimicrob Agents Chemother. 1993;37:778–84.PubMed
48.
go back to reference Lohitnavy M, Lohitnavy O, Thangkeattiyanon O, Srichai W. Reduced oral itraconazole bioavailability by antacid suspension. J Clin Pharm Ther. 2005;30(3):201–6.PubMedCrossRef Lohitnavy M, Lohitnavy O, Thangkeattiyanon O, Srichai W. Reduced oral itraconazole bioavailability by antacid suspension. J Clin Pharm Ther. 2005;30(3):201–6.PubMedCrossRef
49.
go back to reference Freeman J, Heshmati A, Holland D, et al. Marked increase in steady-state serum levels achieved with itraconazole oral solution compared with capsule formulation. J Antimicrob Chemother. 2007;60(4):908–9.PubMedCrossRef Freeman J, Heshmati A, Holland D, et al. Marked increase in steady-state serum levels achieved with itraconazole oral solution compared with capsule formulation. J Antimicrob Chemother. 2007;60(4):908–9.PubMedCrossRef
50.
go back to reference Glasmacher A, Hahn C, Molitor E, et al. Itraconazole trough concentrations in antifungal prophylaxis with six different dosing regimens using hydroxypropyl-beta-cyclodextrin oral solution or coated-pellet capsules. Mycoses. 1999;42(11–12):591–600.PubMedCrossRef Glasmacher A, Hahn C, Molitor E, et al. Itraconazole trough concentrations in antifungal prophylaxis with six different dosing regimens using hydroxypropyl-beta-cyclodextrin oral solution or coated-pellet capsules. Mycoses. 1999;42(11–12):591–600.PubMedCrossRef
51.
go back to reference Poirier JM, Cheymol G. Optimisation of itraconazole therapy using target drug concentrations. Clin Pharmacokinet. 1998;35(6):461–73.PubMedCrossRef Poirier JM, Cheymol G. Optimisation of itraconazole therapy using target drug concentrations. Clin Pharmacokinet. 1998;35(6):461–73.PubMedCrossRef
52.
go back to reference Prentice AG, Glasmacher A. Making sense of itraconazole pharmacokinetics. J Antimicrob Chemother. 2005;56 Suppl 1:i17–22.PubMedCrossRef Prentice AG, Glasmacher A. Making sense of itraconazole pharmacokinetics. J Antimicrob Chemother. 2005;56 Suppl 1:i17–22.PubMedCrossRef
53.
go back to reference Hagihara M, Kasai H, Umemura T, et al. Pharmacokinetic-pharmacodynamic study of itraconazole in patients with fungal infections in intensive care units. J Infect Chemother. 2010 Aug 27 (Epub ahead of print). Hagihara M, Kasai H, Umemura T, et al. Pharmacokinetic-pharmacodynamic study of itraconazole in patients with fungal infections in intensive care units. J Infect Chemother. 2010 Aug 27 (Epub ahead of print).
54.
go back to reference Glasmacher A, Prentice A, Gorschlüter M, et al. Itraconazole prevents invasive fungal infections in neutropenic patients treated for hematologic malignancies: evidence from a meta-analysis of 3,597 patients. J Clin Oncol. 2003;21(24):4615–26.PubMedCrossRef Glasmacher A, Prentice A, Gorschlüter M, et al. Itraconazole prevents invasive fungal infections in neutropenic patients treated for hematologic malignancies: evidence from a meta-analysis of 3,597 patients. J Clin Oncol. 2003;21(24):4615–26.PubMedCrossRef
55.
go back to reference Marr KA, Crippa F, Leisenring W, et al. Itraconazole versus fluconazole for prevention of fungal infections in patients receiving allogeneic stem cell transplants. Blood. 2004;103(4):1527–33.PubMedCrossRef Marr KA, Crippa F, Leisenring W, et al. Itraconazole versus fluconazole for prevention of fungal infections in patients receiving allogeneic stem cell transplants. Blood. 2004;103(4):1527–33.PubMedCrossRef
56.
go back to reference Denning DW, Tucker RM, Hanson LH, et al. Treatment of invasive aspergillosis with itraconazole. Am J Med. 1989;86:791–800.PubMedCrossRef Denning DW, Tucker RM, Hanson LH, et al. Treatment of invasive aspergillosis with itraconazole. Am J Med. 1989;86:791–800.PubMedCrossRef
57.
go back to reference Tucker RM, Denning DW, Dupont B, Stevens DA. Itraconazole therapy for chronic coccidioidal meningitis. Ann Intern Med. 1990;112:108–12.PubMed Tucker RM, Denning DW, Dupont B, Stevens DA. Itraconazole therapy for chronic coccidioidal meningitis. Ann Intern Med. 1990;112:108–12.PubMed
58.
go back to reference Denning DW, Tucker RM, Hanson LH, et al. Itraconazole therapy for cryptococcal meningitis and cryptococcosis. Arch Intern Med. 1989;149:2301–8.PubMedCrossRef Denning DW, Tucker RM, Hanson LH, et al. Itraconazole therapy for cryptococcal meningitis and cryptococcosis. Arch Intern Med. 1989;149:2301–8.PubMedCrossRef
59.
go back to reference • Lestner JM, Roberts SA, Moore CB, et al. Toxicodynamics of itraconazole: implications for therapeutic drug monitoring. Clin Infect Dis. 2009;49(6):928–30. This is the largest and most comprehensive analysis of the relationship between itraconazole drug exposure and adverse events. PubMedCrossRef • Lestner JM, Roberts SA, Moore CB, et al. Toxicodynamics of itraconazole: implications for therapeutic drug monitoring. Clin Infect Dis. 2009;49(6):928–30. This is the largest and most comprehensive analysis of the relationship between itraconazole drug exposure and adverse events. PubMedCrossRef
60.
go back to reference Lestner JM, Denning DW. Tremor: a newly described adverse event with long-term itraconazole therapy. J Neurol Neurosurg Psychiatry. 2010;81:327–9.PubMedCrossRef Lestner JM, Denning DW. Tremor: a newly described adverse event with long-term itraconazole therapy. J Neurol Neurosurg Psychiatry. 2010;81:327–9.PubMedCrossRef
61.
go back to reference Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(3):327–60.PubMedCrossRef Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(3):327–60.PubMedCrossRef
62.
go back to reference Scholz I, Oberwittler H, Riedel KD, et al. Pharmacokinetics, metabolism and bioavailability of the triazole antifungal agent voriconazole in relation to CYP2C19 genotype. Br J Clin Pharmacol. 2009;68(6):906–15.PubMedCrossRef Scholz I, Oberwittler H, Riedel KD, et al. Pharmacokinetics, metabolism and bioavailability of the triazole antifungal agent voriconazole in relation to CYP2C19 genotype. Br J Clin Pharmacol. 2009;68(6):906–15.PubMedCrossRef
63.
go back to reference Myrianthefs P, Markantonis SL, Evaggelopoulou P, et al. Monitoring plasma voriconazole levels following intravenous administration in critically ill patients: an observational study. Int J Antimicrob Agents. 2010;35(5):468–72.PubMedCrossRef Myrianthefs P, Markantonis SL, Evaggelopoulou P, et al. Monitoring plasma voriconazole levels following intravenous administration in critically ill patients: an observational study. Int J Antimicrob Agents. 2010;35(5):468–72.PubMedCrossRef
64.
go back to reference Han K, Capitano B, Bies R, Potoski BA, et al. Bioavailability and population pharmacokinetics of voriconazole in lung transplant recipients. Antimicrob Agents Chemother. 2010;54(10):4424–31.PubMedCrossRef Han K, Capitano B, Bies R, Potoski BA, et al. Bioavailability and population pharmacokinetics of voriconazole in lung transplant recipients. Antimicrob Agents Chemother. 2010;54(10):4424–31.PubMedCrossRef
65.
go back to reference Johnson HJ, Han K, Capitano B, et al. Voriconazole pharmacokinetics in liver transplant recipients. Antimicrob Agents Chemother. 2010;54(2):852–9.PubMedCrossRef Johnson HJ, Han K, Capitano B, et al. Voriconazole pharmacokinetics in liver transplant recipients. Antimicrob Agents Chemother. 2010;54(2):852–9.PubMedCrossRef
66.
go back to reference Trifilio S, Pennick G, Pi J, et al. Monitoring plasma voriconazole levels may be necessary to avoid subtherapeutic levels in hematopoietic stem cell transplant recipients. Cancer. 2007;109(8):1532–5.PubMedCrossRef Trifilio S, Pennick G, Pi J, et al. Monitoring plasma voriconazole levels may be necessary to avoid subtherapeutic levels in hematopoietic stem cell transplant recipients. Cancer. 2007;109(8):1532–5.PubMedCrossRef
67.
go back to reference • Neely M, Rushing T, Kovacs A, et al. Voriconazole pharmacokinetics and pharmacodynamics in children. Clin Infect Dis. 2010;50(1):27–36. This recent retrospective analysis of voriconazole trough concentrations in 46 children observed large interpatient variability and (similar to results reported in adults) an association between a voriconazole trough >1 μg/mL and improved survival, supporting a role for TDM. PubMedCrossRef • Neely M, Rushing T, Kovacs A, et al. Voriconazole pharmacokinetics and pharmacodynamics in children. Clin Infect Dis. 2010;50(1):27–36. This recent retrospective analysis of voriconazole trough concentrations in 46 children observed large interpatient variability and (similar to results reported in adults) an association between a voriconazole trough >1 μg/mL and improved survival, supporting a role for TDM. PubMedCrossRef
68.
go back to reference Walsh TJ, Driscoll T, Milligan PA, et al. Pharmacokinetics, safety, and tolerability of voriconazole in immunocompromised children. Antimicrob Agents Chemother. 2010;54(10):4116–23.PubMedCrossRef Walsh TJ, Driscoll T, Milligan PA, et al. Pharmacokinetics, safety, and tolerability of voriconazole in immunocompromised children. Antimicrob Agents Chemother. 2010;54(10):4116–23.PubMedCrossRef
69.
go back to reference Shima H, Miharu M, Osumi T, et al. Differences in voriconazole trough plasma concentrations per oral dosages between children younger and older than 3 years of age. Pediatr Blood Cancer. 2010;54(7):1050–2.PubMed Shima H, Miharu M, Osumi T, et al. Differences in voriconazole trough plasma concentrations per oral dosages between children younger and older than 3 years of age. Pediatr Blood Cancer. 2010;54(7):1050–2.PubMed
70.
go back to reference Michael C, Bierbach U, Frenzel K, et al. Voriconazole pharmacokinetics and safety in immunocompromised children compared to adult patients. Antimicrob Agents Chemother. 2010;54(8):3225–32.PubMedCrossRef Michael C, Bierbach U, Frenzel K, et al. Voriconazole pharmacokinetics and safety in immunocompromised children compared to adult patients. Antimicrob Agents Chemother. 2010;54(8):3225–32.PubMedCrossRef
72.
go back to reference Denning DW, Ribaud P, et al. Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis. Clin Infect Dis. 2002;34:563–71.PubMedCrossRef Denning DW, Ribaud P, et al. Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis. Clin Infect Dis. 2002;34:563–71.PubMedCrossRef
73.
go back to reference Smith J, Safdar N, Knasinski V, et al. Voriconazole therapeutic drug monitoring. Antimicrob Agents Chemother. 2006;50(4):1570–2.PubMedCrossRef Smith J, Safdar N, Knasinski V, et al. Voriconazole therapeutic drug monitoring. Antimicrob Agents Chemother. 2006;50(4):1570–2.PubMedCrossRef
74.
go back to reference • Pascual A, Calandra T, Bolay S, et al. Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes. Clin Infect Dis. 2008;46(2):201–11. This is the first and only study to date in adults that has observed a significant correlation between prospectively targeted voriconazole plasma concentrations above 1 μg/mL and improved patient outcomes. Correction of suboptimal voriconazole levels in treatment failures was associated with improved outcomes in all patients. PubMedCrossRef • Pascual A, Calandra T, Bolay S, et al. Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes. Clin Infect Dis. 2008;46(2):201–11. This is the first and only study to date in adults that has observed a significant correlation between prospectively targeted voriconazole plasma concentrations above 1 μg/mL and improved patient outcomes. Correction of suboptimal voriconazole levels in treatment failures was associated with improved outcomes in all patients. PubMedCrossRef
75.
go back to reference Trifilio S, Singhal S, Williams S, et al. Breakthrough fungal infections after allogeneic hematopoietic stem cell transplantation in patients on prophylactic voriconazole. Bone Marrow Transplant. 2007;40(5):451–6.PubMedCrossRef Trifilio S, Singhal S, Williams S, et al. Breakthrough fungal infections after allogeneic hematopoietic stem cell transplantation in patients on prophylactic voriconazole. Bone Marrow Transplant. 2007;40(5):451–6.PubMedCrossRef
76.
go back to reference • Wingard JR, Carter SL, Walsh TJ, et al. Randomized double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection (IFI) after allo hematopoietic cell transplantation (HCT). Blood. 2010;116(24):5111–8. The results of this large, randomized, multi-institutional trial in HSCT recipients found fluconazole to be equally efficacious to voriconazole for the prevention of IFI, implying that broadened antifungal prophylaxis may not be of additional benefit. PubMedCrossRef • Wingard JR, Carter SL, Walsh TJ, et al. Randomized double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection (IFI) after allo hematopoietic cell transplantation (HCT). Blood. 2010;116(24):5111–8. The results of this large, randomized, multi-institutional trial in HSCT recipients found fluconazole to be equally efficacious to voriconazole for the prevention of IFI, implying that broadened antifungal prophylaxis may not be of additional benefit. PubMedCrossRef
77.
go back to reference Pongas GN, Lewis RE, Samonis G, et al. Voriconazole-associated zygomycosis: a significant consequence of evolving antifungal prophylaxis and immunosuppression practices? Clin Microbiol Infect. 2009;15 Suppl 5:93–7.PubMedCrossRef Pongas GN, Lewis RE, Samonis G, et al. Voriconazole-associated zygomycosis: a significant consequence of evolving antifungal prophylaxis and immunosuppression practices? Clin Microbiol Infect. 2009;15 Suppl 5:93–7.PubMedCrossRef
78.
go back to reference Tan K, Brayshaw N, Tomaszewski K, et al. Investigation of the potential relationships between plasma voriconazole concentrations and visual adverse events or liver function test abnormalities. J Clin Pharmacol. 2006;46(2):235–43.PubMedCrossRef Tan K, Brayshaw N, Tomaszewski K, et al. Investigation of the potential relationships between plasma voriconazole concentrations and visual adverse events or liver function test abnormalities. J Clin Pharmacol. 2006;46(2):235–43.PubMedCrossRef
79.
go back to reference Gorski E, Esterly J, Postelnick M, et al. An evaluation of hepatotoxicity with off-label oral treatment doses of voriconazole for invasive fungal infections. Antimicrob Agents Chemother. 2011;55(1):184–9.PubMedCrossRef Gorski E, Esterly J, Postelnick M, et al. An evaluation of hepatotoxicity with off-label oral treatment doses of voriconazole for invasive fungal infections. Antimicrob Agents Chemother. 2011;55(1):184–9.PubMedCrossRef
80.
go back to reference Imhof A, Schaer DJ, Schanz U, Schwarz U. Neurological adverse events to voriconazole: evidence for therapeutic drug monitoring. Swiss Med Wkly. 2006;136(45–46):739–42.PubMed Imhof A, Schaer DJ, Schanz U, Schwarz U. Neurological adverse events to voriconazole: evidence for therapeutic drug monitoring. Swiss Med Wkly. 2006;136(45–46):739–42.PubMed
81.
go back to reference Zonios DI, Gea-Banacloche J, Childs R, Bennett JE. Hallucinations during voriconazole therapy. Clin Infect Dis. 2008;47(1):e7–10.PubMedCrossRef Zonios DI, Gea-Banacloche J, Childs R, Bennett JE. Hallucinations during voriconazole therapy. Clin Infect Dis. 2008;47(1):e7–10.PubMedCrossRef
82.
go back to reference Trifilio SM, Yarnold PR, Scheetz MH, et al. Serial plasma voriconazole concentrations after allogeneic hematopoietic stem cell transplantation. Antimicrob Agents Chemother. 2009;53(5):1793–6.PubMedCrossRef Trifilio SM, Yarnold PR, Scheetz MH, et al. Serial plasma voriconazole concentrations after allogeneic hematopoietic stem cell transplantation. Antimicrob Agents Chemother. 2009;53(5):1793–6.PubMedCrossRef
83.
go back to reference Sansone-Parsons A, Krishna G, Calzetta A, et al. Effect of a nutritional supplement on posaconazole pharmacokinetics following oral administration to healthy volunteers. Antimicrob Agents Chemother. 2006;50(5):1881–3.PubMedCrossRef Sansone-Parsons A, Krishna G, Calzetta A, et al. Effect of a nutritional supplement on posaconazole pharmacokinetics following oral administration to healthy volunteers. Antimicrob Agents Chemother. 2006;50(5):1881–3.PubMedCrossRef
84.
go back to reference Courtney R, Wexler D, Radwanski E, Lim J, et al. Effect of food on the relative bioavailability of two oral formulations of posaconazole in healthy adults. Br J Clin Pharmacol. 2004;57(2):218–22.PubMedCrossRef Courtney R, Wexler D, Radwanski E, Lim J, et al. Effect of food on the relative bioavailability of two oral formulations of posaconazole in healthy adults. Br J Clin Pharmacol. 2004;57(2):218–22.PubMedCrossRef
85.
go back to reference Courtney R, Radwanski E, Lim J, et al. Pharmacokinetics of posaconazole coadministered with antacid in fasting or nonfasting healthy men. Antimicrob Agents Chemother. 2004;48(3):804–8.PubMedCrossRef Courtney R, Radwanski E, Lim J, et al. Pharmacokinetics of posaconazole coadministered with antacid in fasting or nonfasting healthy men. Antimicrob Agents Chemother. 2004;48(3):804–8.PubMedCrossRef
86.
go back to reference Ezzet F, Wexler D, Courtney R, Krishna G, Lim J, Laughlin M. Oral bioavailability of posaconazole in fasted healthy subjects: comparison between three regimens and basis for clinical dosage recommendations. Clin Pharmacokinet. 2005;44(2):211–20.PubMedCrossRef Ezzet F, Wexler D, Courtney R, Krishna G, Lim J, Laughlin M. Oral bioavailability of posaconazole in fasted healthy subjects: comparison between three regimens and basis for clinical dosage recommendations. Clin Pharmacokinet. 2005;44(2):211–20.PubMedCrossRef
87.
go back to reference Ullmann A, Cornely O, Burchardt A, et al. Pharmacokinetics, safety, and efficacy of posaconazole in patients with persistent febrile neutropenia or refractory invasive fungal infection. Antimicrob Agents Chemother. 2006;50(2):658–66.PubMedCrossRef Ullmann A, Cornely O, Burchardt A, et al. Pharmacokinetics, safety, and efficacy of posaconazole in patients with persistent febrile neutropenia or refractory invasive fungal infection. Antimicrob Agents Chemother. 2006;50(2):658–66.PubMedCrossRef
88.
go back to reference Li Y, Theuretzbacher C, et al. Pharmacokinetic/pharmacodynamic profile of posaconazole. Clin Pharmacokinet. 2010;49(6):379–96.PubMedCrossRef Li Y, Theuretzbacher C, et al. Pharmacokinetic/pharmacodynamic profile of posaconazole. Clin Pharmacokinet. 2010;49(6):379–96.PubMedCrossRef
89.
go back to reference Greenberg RN, Mullane K, van Burik JA, et al. Posaconazole as salvage therapy for zygomycosis. Antimicrob Agents Chemother. 2006;50(1):126–33.PubMedCrossRef Greenberg RN, Mullane K, van Burik JA, et al. Posaconazole as salvage therapy for zygomycosis. Antimicrob Agents Chemother. 2006;50(1):126–33.PubMedCrossRef
90.
go back to reference Walsh TJ, Raad I, Patterson TF, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis. 2007;44:2–12.PubMedCrossRef Walsh TJ, Raad I, Patterson TF, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis. 2007;44:2–12.PubMedCrossRef
91.
go back to reference Shields RK, Clancy CJ, Vadnerkar A, et al. Posaconazole serum concentrations among cardiothoracic transplant recipients: factors impacting trough levels and correlation with clinical response to therapy. Antimicrob Agents Chemother. 2011;55(3):1308–11.PubMedCrossRef Shields RK, Clancy CJ, Vadnerkar A, et al. Posaconazole serum concentrations among cardiothoracic transplant recipients: factors impacting trough levels and correlation with clinical response to therapy. Antimicrob Agents Chemother. 2011;55(3):1308–11.PubMedCrossRef
92.
go back to reference Oliver A, Cornely O, Maertens J, Drew J, et al. Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007;356:348–59.CrossRef Oliver A, Cornely O, Maertens J, Drew J, et al. Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007;356:348–59.CrossRef
93.
go back to reference Ullmann AJ, Lipton JH, Vesole DH, et al. Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med. 2007;356(4):335–47.PubMedCrossRef Ullmann AJ, Lipton JH, Vesole DH, et al. Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med. 2007;356(4):335–47.PubMedCrossRef
94.
go back to reference Thompson G, Rinaldi M, Pennick G, et al. Posaconazole therapeutic drug monitoring: a reference laboratory experience. Antimicrob Agents Chemother. 2009;53(5):2223–4.PubMedCrossRef Thompson G, Rinaldi M, Pennick G, et al. Posaconazole therapeutic drug monitoring: a reference laboratory experience. Antimicrob Agents Chemother. 2009;53(5):2223–4.PubMedCrossRef
95.
go back to reference Migoya EM, Mistry GC, Stone JA, et al. Safety and pharmacokinetics of higher doses of caspofungin in healthy adult participants. J Clin Pharmacol. 2011;51(2):202–11.PubMedCrossRef Migoya EM, Mistry GC, Stone JA, et al. Safety and pharmacokinetics of higher doses of caspofungin in healthy adult participants. J Clin Pharmacol. 2011;51(2):202–11.PubMedCrossRef
96.
go back to reference Lewis RE, Albert ND, Kontoyiannis DP, et al. Comparison of the dose-dependent activity and paradoxical effect of caspofungin and micafungin in a neutropenic murine model of invasive pulmonary aspergillosis. J Antimicrob Chemother. 2008;61(5):1140–4.PubMedCrossRef Lewis RE, Albert ND, Kontoyiannis DP, et al. Comparison of the dose-dependent activity and paradoxical effect of caspofungin and micafungin in a neutropenic murine model of invasive pulmonary aspergillosis. J Antimicrob Chemother. 2008;61(5):1140–4.PubMedCrossRef
97.
go back to reference Horn DL, Ostrosky-Zeichner L, Morris MI, et al. Factors related to survival and treatment success in invasive candidiasis or candidemia: a pooled analysis of two large, prospective, micafungin trials. Eur J Clin Microbiol Infect Dis. 2010;29(2):223–9.PubMedCrossRef Horn DL, Ostrosky-Zeichner L, Morris MI, et al. Factors related to survival and treatment success in invasive candidiasis or candidemia: a pooled analysis of two large, prospective, micafungin trials. Eur J Clin Microbiol Infect Dis. 2010;29(2):223–9.PubMedCrossRef
98.
go back to reference Hope W, Seibel N, Schwartz C, et al. Population pharmacokinetics of micafungin in pediatric patients and implications for antifungal dosing. Antimicrob Agents Chemother. 2007;51(10):3714–9.PubMedCrossRef Hope W, Seibel N, Schwartz C, et al. Population pharmacokinetics of micafungin in pediatric patients and implications for antifungal dosing. Antimicrob Agents Chemother. 2007;51(10):3714–9.PubMedCrossRef
99.
go back to reference Neely M, Jafri H, Seibel N, et al. Pharmacokinetics and safety of caspofungin in older infants and toddlers. Antimicrob Agents Chemother. 2009;53(4):1450–6.PubMedCrossRef Neely M, Jafri H, Seibel N, et al. Pharmacokinetics and safety of caspofungin in older infants and toddlers. Antimicrob Agents Chemother. 2009;53(4):1450–6.PubMedCrossRef
Metadata
Title
Update on Antifungal Drug Dosing and Therapeutic Drug Monitoring
Author
Steven Trifilio
Publication date
01-06-2011
Publisher
Current Science Inc.
Published in
Current Fungal Infection Reports / Issue 2/2011
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-011-0050-1

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