지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
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Background : Voriconazole is a first-line agent for treatment of invasive aspergillosis. However, the relationship between dose and serum concentration of voriconazole is non-linear, making it very difficult to predict changes in serum level of voriconazole upon dosage change. Here, we reviewed and analyzed cases of changing dose of voriconazole when its serum concentration was not within therapeutic range. Methods : We retrospectively analyzed medical records of adult patients who were hospitalized in Asan Medical Center from January 2010 to December 2015. We excluded cases whose voriconazole level was not in a steady state, those who were administered incompatible drugs, and those who were diagnosed with liver cirrhosis. The number of hospitalization was the unit of analysis. Patients were classified by their initial serum concentration of voriconazole as follows: Group 1 (G1) (TDM1; 1st level 0.5 ㎍/ml), G2 (0.5≤TDM1 1 ㎍/ml), G3 (1≤TDM1 5.5 ㎍/ml (therapeutic range)), G4 (5.5 ≤ TDM1 10 ㎍/ml) and G5 (TDM1≥10 ㎍/ml). Chi-square test and Fisher’s exact test were used to test if there were statistical differences between groups. This study was approved by our Institutional Review Board (No. S2016-1134-0001). Results : A total of 574 cases were analyzed and classified into five groups. We found that 93%, 82%, 87% and 76% of G1, G2, G4 and G5, respectively, reached therapeutic range of voriconazole when their dosages were changed as follows: increased by 2 mg/kg/day, increased by 0.5 mg/kg/day, decreased by ≥1 mg/kg/day and decreased by ≥2 mg/kg/day, respectively. Conclusions : The following dose changing regimen would be more reasonable when serum level of voriconazole is not within therapeutic range: G1, increase by 2-5 mg/kg/day; G2, increase by 0.5-2.5 mg/kg/day; G4, decrease by 1.5-4 mg/kg/day; G5, skip one dose and decrease by 2.5-4 mg/kg/day.
목차
등록된 정보가 없습니다.
참고문헌 (25)
참고문헌 신청
Walsh TJ / 2008 / Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America / Clin Infect Dis 46(3):327~360
Korea pharmaceutical information center / 0000 / KPIC Drug Information
Yamada T / 2015 / Saturated metabolism of voriconazole N-Oxidation resulting in nonlinearity of pharmacokinetics of voriconazole at clinical doses / Biol Pharm Bull 38(10):1496~1503
Dolton MJ / 2012 / Multicenter study of voriconazole pharmacokinetics and therapeutic drug monitoring / Antimicrob Agents Chemother 56(1-1):4793~4799
Weiler S / 2007 / Altered pharmacokinetics of voriconazole in a patient with liver cirrhosis / Antimicrob Agents Chemother 51(9):3459~3460
Korea pharmaceutical information center / 0000 / KPIC Drug Information
Yamada T / 2015 / Saturated metabolism of voriconazole N-Oxidation resulting in nonlinearity of pharmacokinetics of voriconazole at clinical doses / Biol Pharm Bull 38(10):1496~1503
Dolton MJ / 2012 / Multicenter study of voriconazole pharmacokinetics and therapeutic drug monitoring / Antimicrob Agents Chemother 56(1-1):4793~4799
Weiler S / 2007 / Altered pharmacokinetics of voriconazole in a patient with liver cirrhosis / Antimicrob Agents Chemother 51(9):3459~3460
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