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Journal of Antimicrobial Chemotherapy 2004 54(1):269-270; doi:10.1093/jac/dkh310
JAC vol.54 no.1 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.

Disposition of voriconazole during continuous veno-venous haemodiafiltration (CVVHDF) in a single patient

C. Robatel1, M. Rusca2, C. Padoin3, O. Marchetti4, L. Liaudet2 and T. Buclin1,*

1 Division of Clinical Pharmacology and Toxicology; 2 Division of Intensive Care Medicine; 4 Infectious Diseases Service, Department of Medicine, University Hospital, 1011 Lausanne, Switzerland; 3 Pharmacy Department—CREPIT 93, Avicenne Hospital, Bobigny, France

* Corresponding author. Tel: +41-21-314-42-61; Fax: +41-21-314-42-66; Email: thierry.buclin{at}chuv.hospvd.ch

Objectives: To determine whether voriconazole dosage adjustment is required during continuous veno-venous haemodiafiltration (CVVHDF).

Methods: Voriconazole pharmacokinetics were studied in a critically ill patient under CVVHDF. The analysis was carried out for 12 h following a 6 mg/kg dose. Voriconazole concentrations were measured by HPLC in blood inlet and outlet lines and in dialysate.

Results: The total body clearance of voriconazole was 20.3 L/h, with a terminal half-life of 13.7 h and a distribution volume of 399 L. The estimated sieving coefficient was 0.53 and the filtration-dialysis clearance 1.2 L/h.

Conclusions: CVVHDF does not significantly affect voriconazole disposition and requires no dosage adjustment.

Keywords: antifungals , renal failure , dialysis , pharmacokinetics


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