Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
Med Mycol. 2012 May;50(4):439-45. doi: 10.3109/13693786.2011.630039. Epub 2011 Nov 9.
In this study we present the results of a therapeutic drug monitoring retrospective analysis involving 14 patients with several underlying diseases who were receiving voriconazole for the treatment of fungal infections. A simple high performance liquid chromatography assay with ultraviolet detection was used in the drug monitoring. We report here that serum concentrations were highly variable and unpredictable in most patients. We also found that lack of response was more frequent in patients with levels persistently lower than 1 mg/l. The number of samples with voriconazole concentrations below 1 mg/l was significantly higher in patients who exhibited therapeutic failures (88% versus 27%; P < 0.001). In addition, the period of time in which voriconazole concentrations were maintained below 1 mg/l was slightly higher in patients in the failure group. We suggest that serum concentration should be individually quantified for patients receiving voriconazole therapy. Further prospective studies are needed to clarify the potential benefit of the individualization of treatment.
在这项研究中，我们呈现了涉及 14 名患有多种基础疾病的患者的治疗药物监测回顾性分析结果，这些患者正在接受伏立康唑治疗真菌感染。在药物监测中使用了一种简单的高效液相色谱法结合紫外检测。我们在此报告，大多数患者的血清浓度高度可变且不可预测。我们还发现，在血清浓度持续低于 1mg/L 的患者中，无反应更为常见。在治疗失败的患者中，伏立康唑浓度低于 1mg/L 的样本数量明显更高（88%对 27%；P<0.001）。此外，在失败组中，伏立康唑浓度持续低于 1mg/L 的时间稍长。我们建议应对接受伏立康唑治疗的患者进行个体化的血清浓度定量。需要进一步的前瞻性研究来阐明治疗个体化的潜在益处。
