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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorValle-T-Figueras, Jose María
dc.contributor.authorRenedo Miro, Berta
dc.contributor.authorBenitez Carabante, Maria Isabel
dc.contributor.authorDíaz de Heredia Rubio, Maria Cristina
dc.contributor.authorVima Bofarull, Jaume
dc.contributor.authorMendoza Palomar, Natalia Ana
dc.contributor.authorMartin Gomez, M Teresa
dc.contributor.authorSoler Palacín, Pere
dc.date.accessioned2022-03-01T07:31:13Z
dc.date.available2022-03-01T07:31:13Z
dc.date.issued2021-06
dc.identifier.citationValle-T-Figueras JM, Renedo Miró B, Benítez Carabante MI, Díaz-de-Heredia C, Vima Bofarull J, Mendoza-Palomar N, et al. Voriconazole Use in Children: Therapeutic Drug Monitoring and Control of Inflammation as Key Points for Optimal Treatment. J Fungi. 2021 Jun;7(6):456.
dc.identifier.issn2309-608X
dc.identifier.urihttp://hdl.handle.net/11351/7101
dc.descriptionPaediatric fungal infections; Therapeutic drug monitoring; Voriconazole
dc.description.abstractVoriconazole plasma concentrations (PC) are highly variable, particularly in children. Dose recommendations in 2–12-year-old patients changed in 2012. Little data on therapeutic drug monitoring (TDM) after these new recommendations are available. We aimed to evaluate voriconazole monitoring in children with invasive fungal infection (IFI) after implementation of new dosages and its relationship with safety and effectiveness. A prospective, observational study, including children aged 2–12 years, was conducted. TDM was performed weekly and doses were changed according to an in-house protocol. Effectiveness, adverse events, and factors influencing PC were analysed. A total of 229 PC from 28 IFI episodes were obtained. New dosing led to a higher rate of adequate PC compared to previous studies; still, 35.8% were outside the therapeutic range. In patients aged < 8 years, doses to achieve therapeutic levels were higher than recommended. Severe hypoalbuminemia and markedly elevated C-reactive protein were related to inadequate PC. Therapeutic PC were associated with drug effectiveness and safety. Higher doses in younger patients and a dose adjustment protocol based on TDM should be considered. Voriconazole PC variability has decreased with current updated recommendations, but it remains high and is influenced by inflammatory status. Additional efforts to control inflammation in children with IFI should be encouraged.
dc.language.isoeng
dc.publisherMDPI
dc.relation.ispartofseriesJournal of Fungi;7(6)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectMedicaments antifúngics - Ús terapèutic
dc.subjectPosologia
dc.subjectMalalties transmissibles - Tractament
dc.subject.meshTreatment Outcome
dc.subject.meshAntifungal Agents
dc.subject.mesh/administration & dosage
dc.subject.meshCommunicable Diseases
dc.titleVoriconazole Use in Children: Therapeutic Drug Monitoring and Control of Inflammation as Key Points for Optimal Treatment
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.3390/jof7060456
dc.subject.decsresultado del tratamiento
dc.subject.decsantifúngicos
dc.subject.decs/administración & dosificación
dc.subject.decsenfermedades transmisibles
dc.relation.publishversionhttps://doi.org/10.3390/jof7060456
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Valle-T-Figueras JM] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Department of Paediatrics, Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Renedo Miró B] Servei de Farmàcia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Benítez Carabante MI, Díaz-de-Heredia C] Servei d’Oncologia i Hematologia Pediàtriques, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Vima Bofarull J] Servei de Bioquímica Clínica, Laboratoris Clínics Centrals, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Mendoza-Palomar N, Soler-Palacín P] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Martín-Gómez MT] Servei de Microbiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
dc.identifier.pmid34200506
dc.identifier.wos000666633900001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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