ArticleAntimicrobial agents and chemotherapy2013
Highly variable plasma concentrations of voriconazole in pediatric hematopoietic stem cell transplantation patients.
Article in Antimicrobial agents and chemotherapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Clinical application of voriconazole in pediatric patients: a systematic review.Italian journal of pediatrics · 2024Pooled it
- Associated factors with voriconazole plasma concentration: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Individualized Medication of Voriconazole: A Practice Guideline of the Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society.Therapeutic drug monitoring · 2018Guideline
- Voriconazole therapeutic drug monitoring: results of a prematurely discontinued randomized multicenter trial.Transplant infectious disease : an official journal of the Transplantation Society · 2015Trial
- A physiologically based pharmacokinetic model for voriconazole disposition predicts intestinal first-pass metabolism in children.Clinical pharmacokinetics · 2014Trial
- Voriconazole in the treatment of pediatric patients with hematologic malignancies and invasive fungal infections: a real-world study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Therapeutic Drug Monitoring of Antimicrobial Drugs in Children with Cancer: A New Tool for Personalized Medicine.Paediatric drugs · 2025Review
- Precision dosing of voriconazole in immunocompromised children under 2 years: integrated machine learning and population pharmacokinetic modeling.Frontiers in pharmacology · 2025Article
- Voriconazole therapeutic drug monitoring including analysis of CYP2C19 phenotype in immunocompromised pediatric patients with invasive fungal infections.European journal of clinical pharmacology · 2024Article
- Impact of Inflammatory Burden on Voriconazole Exposure in Oncohematological Pediatric Patients Receiving Antifungal Prophylaxis after Allogeneic HCT.Microorganisms · 2024Article
- Landscape of Invasive Fusariosis in Pediatric Cancer Patients: Results of a Multicenter Observational Study From Latin America.Open forum infectious diseases · 2024Article
- Therapeutic Drug Monitoring of Voriconazole in Critically Ill Pediatric Patients: A Single-Center Retrospective Study.Paediatric drugs · 2024Article
- Higher Weight-Based Doses Are Required to Achieve and Maintain Therapeutic Voriconazole Serum Trough Concentrations in Children.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2023Article
- Challenges in the Treatment of Invasive Aspergillosis in Immunocompromised Children.Antimicrobial agents and chemotherapy · 2022Review
- Pharmacogenetic Analysis of Voriconazole Treatment in Children.Pharmaceutics · 2022Article
- Combined Effect ofFrontiers in pediatrics · 2022Article
- Factors Affecting Voriconazole Trough Concentration and Optimal Maintenance Voriconazole Dose in Chinese Children.Antibiotics (Basel, Switzerland) · 2021Article
- Recent Advances in Therapeutic Drug Monitoring of Voriconazole, Mycophenolic Acid, and Vancomycin: A Literature Review of Pediatric Studies.Pharmaceutics · 2021Review
- Impact of CYP2C19 Phenotype and Drug-Drug Interactions on Voriconazole Concentration in Pediatric Patients.Antimicrobial agents and chemotherapy · 2021Article
- Model-Oriented Dose Optimization of Voriconazole in Critically Ill Children.Antimicrobial agents and chemotherapy · 2021Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Invasive fungal infections are of great concern in pediatric hematopoietic stem cell transplantation (HSCT) recipients. Voriconazole is usually the drug of first choice for treating or preventing invasive aspergillosis. Optimum trough levels (C(trough)s) are between 1 and 5 mg/liter. It is unclear whether these levels are reached with currently advised pediatric dosing schedules. Between 2007 and 2011, 11 patients <2 years of age, 31 between 2 and 12 years, and 20 between 12 and 20 years were (prophylactically or therapeutically) treated with voriconazole in the HSCT unit of UMC Utrecht. For children <2 years of age, the dosage recommended for 2 to 12 years was used. In 34% of children who started with the recommended dose, an adequate C(trough) was reached irrespective of age or administration route. After therapeutic drug monitoring (TDM)-based dose adjustments, adequate C(trough)s were reached in 80% of the patients at median doses of 31.5 (age, <2 years), 16 (age, 2 to 12 years), and 9.4 mg/kg of body weight/day (age, >12 years) (P = 0.034). The intrapatient variability in C(trough) ranged between 1 and 238%. Voriconazole was discontinued in six patients due to toxicity. These patients had a median C(trough) of 0.5 mg/liter at the initial dose (ranging from 0.5 to 2.6 mg/liter), and a medium maximal concentration of 4 mg/liter was reached. Inter- and intrapatient variability is a major concern in voriconazole treatment and necessitates therapeutic drug monitoring of dosing, especially in young children.
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