氟氯西林与唑类药物的相互作用：下一个是伊曲康唑吗？
Interaction between flucloxacillin and azoles: Is isavuconazole next?
机构信息
Department of Pharmaceutical and Pharmacological Sciences, KU Leuven and Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
Department of Microbiology, Immunology and Transplantation, KU Leuven and Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
出版信息
Mycoses. 2021 Dec;64(12):1508-1511. doi: 10.1111/myc.13373. Epub 2021 Oct 9.
BACKGROUND
Isavuconazole is a triazole antifungal drug, approved for the treatment of invasive aspergillosis and mucormycosis. It has been previously reported that an interaction between flucloxacillin and voriconazole may lead to subtherapeutic voriconazole exposure, when used concomitantly. Since isavuconazole is also metabolised via cytochrome P450 enzymes, the same interaction may be expected.
OBJECTIVES
We aim to document exposure to isavuconazole in patients concomitantly treated with flucloxacillin.
PATIENTS
We report two patients treated with both isavuconazole and flucloxacillin, in whom we determined isavuconazole concentrations.
RESULTS
Low isavuconazole trough concentrations (<1 mg/L) were observed in two patients under concomitant treatment with flucloxacillin.
CONCLUSIONS
In combination with flucloxacillin, low isavuconazole concentrations were observed but an adequate isavuconazole exposure may be reached with dose augmentation. Therapeutic drug monitoring of isavuconazole is recommended to ensure an adequate exposure.
背景
伊曲康唑是一种三唑类抗真菌药物，已被批准用于治疗侵袭性曲霉病和毛霉病。先前有报道称，氟氯西林和伏立康唑同时使用可能会导致伏立康唑暴露不足，因为伊曲康唑也通过细胞色素 P450 酶代谢，因此可能会出现相同的相互作用。
目的
我们旨在记录同时接受氟氯西林治疗的患者中伊曲康唑的暴露情况。
患者
我们报告了两名同时接受伊曲康唑和氟氯西林治疗的患者，我们在这两名患者中测定了伊曲康唑的浓度。
结果
在两名同时接受氟氯西林治疗的患者中，观察到伊曲康唑谷浓度较低（<1 mg/L）。
结论
与氟氯西林联合使用时，观察到伊曲康唑浓度较低，但通过增加剂量可能达到足够的伊曲康唑暴露。建议对伊曲康唑进行治疗药物监测，以确保充分暴露。
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