Skip Navigation


JAC Advance Access originally published online on November 12, 2007
Journal of Antimicrobial Chemotherapy 2008 61(1):17-25; doi:10.1093/jac/dkm389
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
61/1/17    most recent
dkm389v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (14)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Goodwin, M. L.
Right arrow Articles by Drew, R. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Goodwin, M. L.
Right arrow Articles by Drew, R. H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Review

Antifungal serum concentration monitoring: an update

Megan L. Goodwin1,* and Richard H. Drew2,3

1 Department of Pharmacy, Carilion Roanoke Memorial Hospital, Roanoke, VA, USA 2 Duke School of Medicine, Durham, NC, USA 3 Campbell University School of Pharmacy, Buies Creek, NC, USA

* Corresponding author. Tel: +1-540-981-7275; Fax: +1-540-981-8196; E-mail: mlgoodwin2005{at}gmail.com

Invasive fungal infections (IFIs) are occurring with increasing incidence and are associated with significant morbidity and mortality. Understanding the relationship between the pharmacokinetic and pharmacodynamic properties of antifungals is essential to optimize the potential for favourable clinical and microbiological outcomes while minimizing risks of treatment-related toxicity. Antifungal serum concentrations may aid in the determination of appropriate dosing in select circumstances. The polyene and echinocandin classes of antifungals lack sufficient data to justify serum concentration monitoring in routine clinical practice. In contrast, serum concentration monitoring of flucytosine may help to reduce the risk of treatment-related haematological toxicity. Determination of itraconazole serum concentrations is advised in situations where the drug is used for prolonged periods to treat serious IFIs (such as invasive aspergillosis or histoplasmosis) because of variability in absorption following oral administration (most notable for the capsule formulation). The use of serum concentration monitoring during therapy with the extended-spectrum triazoles (i.e. voriconazole and posaconazole) is still evolving, due primarily to inter-patient variability in drug exposure combined with sparse data regarding relationships with efficacy (posaconazole) and both safety and efficacy (voriconazole).

Keywords: pharmacodynamics , pharmacokinetics , azoles


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J Antimicrob ChemotherHome page
S. Cronin and P. H. Chandrasekar
Safety of triazole antifungal drugs in patients with cancer
J. Antimicrob. Chemother., March 1, 2010; 65(3): 410 - 416.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
C. W. Nemerovski, E. R. Mackler, D. D. DePestel, C. D. Collins, K. S. Welch, and J. G. Stevenson
Drug costs and utilization after implementation of a posaconazole prophylaxis protocol in adults with acute myelogenous leukemia
Am. J. Health Syst. Pharm., February 15, 2010; 67(4): 295 - 299.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
S. M. Trifilio, P. R. Yarnold, M. H. Scheetz, J. Pi, G. Pennick, and J. Mehta
Serial Plasma Voriconazole Concentrations after Allogeneic Hematopoietic Stem Cell Transplantation
Antimicrob. Agents Chemother., May 1, 2009; 53(5): 1793 - 1796.
[Abstract] [Full Text] [PDF]

Home page
 Drug Metab. Dispos.Home page
J. C. Talakad, S. Kumar, and J. R. Halpert
Decreased Susceptibility of the Cytochrome P450 2B6 Variant K262R to Inhibition by Several Clinically Important Drugs
Drug Metab. Dispos., March 1, 2009; 37(3): 644 - 650.
[Abstract] [Full Text] [PDF]

Home page
 The Annals of PharmacotherapyHome page
A. Howard, J. Hoffman, and A. Sheth
Clinical Application of Voriconazole Concentrations in the Treatment of Invasive Aspergillosis
Ann. Pharmacother., December 1, 2008; 42(12): 1859 - 1864.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.