Curr Fungal Infect Rep (2017) 11:75–83 DOI 10.1007/s12281-017-0287-4 CURRENT MANAGEMENT OF FUNGAL INFECTIONS (M MICELI, SECTION EDITOR) Update on Therapeutic Drug Monitoring of Antifungals for the Prophylaxis and Treatment of Invasive Fungal Infections 1,2,3 3,4 Ilan S. Schwartz & Nathan P. Wiederhold Published online: 1 July 2017 Springer Science+Business Media, LLC 2017 . . . Abstract Keywords Azoles Invasive fungal infections Mycoses . . Purpose of Review Certain antifungals used as therapy for Voriconazole Posaconazole Isavuconazole invasive fungal disease, including the extended-spectrum triazoles, may be limited by variable pharmacokinetics and drug interactions. This is especially important when drug ex- Introduction posure, as measured by trough concentrations, may be linked to either efficacy or toxicity. We review the rationale, indica- The management of patients with invasive fungal infections tions, and controversies in TDM of antifungals. has advanced since the days when only amphotericin B Recent Findings The monitoring of voriconazole drug levels deoxycholate was available in the clinician’s armamentarium. is often practiced in patients that receive this triazole based on The availability of lipid formulations of amphotericin B, clinical data. Posaconazole delayed-release tablets achieve extended-spectrum triazoles, and the echinocandins, a rela- higher drug exposure more consistently, necessitating recon- tively new
Current Fungal Infection Reports – Springer Journals
Published: Jul 1, 2017
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