Therapeutic drug monitoring of systemic antifungal therapy

被引:41
作者
Summers, KK
Hardin, TC
Gore, SJ
Graybill, JR
机构
[1] Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA
[2] Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA
[3] S Texas Vet Hlth Care Syst, San Antonio, TX USA
关键词
D O I
10.1093/jac/40.6.753
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The use of systemic antifungal therapy has significantly increased in recent years. Individualization of antifungal therapy through the use of serum or plasma concentrations has been suggested, although no specific recommendations have been developed. The important criteria for therapeutic drug monitoring and which of these criteria are satisfied by systemic antifungal agents are presented in this review. No one antifungal is ideally suited for application of therapeutic drug monitoring, but, under certain circumstances, obtaining serum or plasma concentrations can be justified. In patients who are susceptible to flucytosine toxicity, serum flucytosine concentrations should be monitored in an effort to avoid untoward side-effects. In contrast, therapeutic drug monitoring of amphotericin B is not recommended in the clinical setting. Demonstrating that ketoconazole and itraconazole are reaching the systemic circulation by obtaining serum concentrations may be clinically useful due to the large variability in their absorption and issues of patient compliance which may be seen with these agents. The bioavailability of fluconazole is much less varied although validation of compliance is a situation where obtaining serum concentrations may provide additional information.
引用
收藏
页码:753 / 764
页数:12
相关论文
共 59 条
[1]   SAFETY, PLASMA-CONCENTRATIONS, AND EFFICACY OF HIGH-DOSE FLUCONAZOLE IN INVASIVE MOLD INFECTIONS [J].
ANAISSIE, EJ ;
KONTOYIANNIS, DP ;
HULS, C ;
VARTIVARIAN, SE ;
KARL, C ;
PRINCE, RA ;
BOSSO, J ;
BODEY, GP .
JOURNAL OF INFECTIOUS DISEASES, 1995, 172 (02) :599-602
[2]   CORRELATION BETWEEN IN-VITRO AND IN-VIVO ACTIVITY OF ANTIFUNGAL AGENTS AGAINST CANDIDA SPECIES [J].
ANAISSIE, EJ ;
KARYOTAKIS, NC ;
HACHEM, R ;
DIGNANI, MC ;
REX, JH ;
PAETZNICK, V .
JOURNAL OF INFECTIOUS DISEASES, 1994, 170 (02) :384-389
[3]   QUANTITATIVE EXTRACTION OF AMPHOTERICIN-B FROM SERUM AND ITS DETERMINATION BY HIGH-PRESSURE LIQUID-CHROMATOGRAPHY [J].
BACH, PR .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1984, 26 (03) :314-317
[4]   COMPARISON OF AMPHOTERICIN-B ALONE AND COMBINED WITH FLUCYTOSINE IN THE TREATMENT OF CRYPTOCCAL MENINGITIS [J].
BENNETT, JE ;
DISMUKES, WE ;
DUMA, RJ ;
MEDOFF, G ;
SANDE, MA ;
GALLIS, H ;
LEONARD, J ;
FIELDS, BT ;
BRADSHAW, M ;
HAYWOOD, H ;
MCGEE, ZA ;
CATE, TR ;
COBBS, CG ;
WARNER, JF ;
ALLING, DW .
NEW ENGLAND JOURNAL OF MEDICINE, 1979, 301 (03) :126-131
[5]   A PHARMACOLOGIC GUIDE TO CLINICAL USE OF AMPHOTERICIN B [J].
BINDSCHADLER, DD ;
BENNETT, JE .
JOURNAL OF INFECTIOUS DISEASES, 1969, 120 (04) :427-+
[6]   PHARMACOLOGICAL STUDIES WITH 5-FLUOROCYTOSINE [J].
BLOCK, ER ;
BENNETT, JE .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1972, 1 (06) :476-&
[7]   ANTIFUNGAL PROPHYLAXIS WITH ITRACONAZOLE IN PROLONGED NEUTROPENIA - CORRELATION WITH PLASMA-LEVELS [J].
BOOGAERTS, MA ;
VERHOEF, GE ;
ZACHEE, P ;
DEMUYNCK, H ;
VERBIST, L ;
DEBEULE, K .
MYCOSES, 1989, 32 :103-108
[8]   PHARMACOKINETICS OF FLUCONAZOLE IN PEDIATRIC-PATIENTS [J].
BRAMMER, KW ;
COATES, PE .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 1994, 13 (04) :325-329
[9]  
BRAMMER KW, 1990, REV INFECT DIS, V12, pS318
[10]   HIGH-PERFORMANCE LIQUID-CHROMATOGRAPHIC DETERMINATION OF AMPHOTERICIN-B IN HUMAN-SERUM [J].
BRASSINNE, C ;
LADURON, C ;
COUNE, A ;
SCULIER, JP ;
HOLLAERT, C ;
COLLETTE, N ;
MEUNIER, F .
JOURNAL OF CHROMATOGRAPHY-BIOMEDICAL APPLICATIONS, 1987, 419 :401-407