Valenzuela Romina, Torres Juan P, Salas Carolina, Gajardo Iván, Palma Julia, Catalán Paula, Santolaya M Elena, Morales Jorge
Departamento de Pediatría Unidad de Investigación, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Unidad de Trasplante de Medula Ósea, Hospital Dr. Luis Calvo Mackenna, Chile.
Rev Chilena Infectol. 2017 Feb;34(1):14-18. doi: 10.4067/S0716-10182017000100002.
Drug interactions (DI) in patients receiving hematopoietic stem cell transplantation (HSCT) are common and clinically significant, highlighting: anticonvulsants, voriconazole (VCZ) and cyclosporine (CsA), which require monitoring.
To describe the interactions between CsA-VCZ in children undergoing HSCT.
Retrospective, descriptive study in immunocompromised children hospitalized since January 2013 to December 2014 at Bone Marrow Transplant Unit, Hospital Dr. Luis Calvo Mackenna, who received CsA and VCZ.
The median age was 5 years (3-6) and the median weight was 20 kg (17-30). Sixtythree baseline drug levels were analyzed, of those, 27 were CsA drug levels obtained previous to using VCZ and 36 were CsA drug levels collected concomitantly with VCZ. In the group CsA previous to VCZ, the CsA dose was 4.6 ± 2.6 (mg/ kg/ day) and the CsA average level was 188.8 ± 84.1 (μg/ml). In the group of CsA concomitantly with VCZ, the dose of CsA was 5.5 ± 3.0 (mg/ kg/day) (p = 0.07) and CsA average level was significantly higher: 232.5 ± 106.7 (μg/ml) (p = 0.04).
This study shows an increased level of CsA when it is used together with VCZ. Therapeutic drug monitoring could improve the management of the DI and optimize the co-administration of CsA and VCZ.
接受造血干细胞移植（HSCT）的患者中药物相互作用（DI）很常见且具有临床意义，其中突出的有：抗惊厥药、伏立康唑（VCZ）和环孢素（CsA），这些需要进行监测。
描述接受HSCT的儿童中CsA与VCZ之间的相互作用。
对2013年1月至2014年12月在路易斯·卡尔沃·麦肯纳博士医院骨髓移植科住院的接受CsA和VCZ治疗的免疫功能低下儿童进行回顾性描述性研究。
中位年龄为5岁（3 - 6岁），中位体重为20千克（17 - 30千克）。分析了63个基线药物水平，其中27个是使用VCZ之前获得的CsA药物水平，36个是与VCZ同时采集的CsA药物水平。在使用VCZ之前的CsA组中，CsA剂量为4.6±2.6（毫克/千克/天），CsA平均水平为188.8±84.1（微克/毫升）。在与VCZ同时使用的CsA组中，CsA剂量为5.5±3.0（毫克/千克/天）（p = 0.07），CsA平均水平显著更高：232.5±106.7（微克/毫升）（p = 0.04）。
本研究表明，CsA与VCZ联合使用时其水平会升高。治疗药物监测可改善药物相互作用的管理，并优化CsA和VCZ的联合给药。
