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JAC Advance Access published online on June 2, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh310
© 2004 by The British Society for Antimicrobial Chemotherapy
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Received March 4, 2004
Revised April 15, 2000
Accepted May 4, 2004

Brief report

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

C. Robatel 1, M. Rusca 2, C. Padoin 3, O. Marchetti 4, L. Liaudet 2, T. Buclin 1*

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

* To whom correspondence should be addressed. E-mail: thierry.buclin{at}chuv.hospvd.ch.


  Abstract

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.

Key Words: Keywords: antifungals, renal failure, dialysis, pharmacokinetics


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