ArticleAnnals of clinical microbiology and antimicrobials2017
Voriconazole and posaconazole therapeutic drug monitoring: a retrospective study.
Article in Annals of clinical microbiology and antimicrobials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- Associated factors with voriconazole plasma concentration: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Posaconazole therapeutic drug monitoring in pediatrics: a single-center retrospective study.BMC pediatrics · 2026Article
- Antifungal treatment strategies and their impact on resistance development in clinical settings.The Journal of antimicrobial chemotherapy · 2025Review
- Evaluation of voriconazole therapeutic drug monitoring in malignant hematology patients.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2025Article
- Managing Invasive Fungal Infections During Allogeneic Hematopoietic Transplantation: A 2025 Update.Mediterranean journal of hematology and infectious diseases · 2025Review
- Plasma concentration of voriconazole under concomitant use of nirmatrelvir/ritonavir in patients with COVID-19: a multicenter retrospective study.Frontiers in pharmacology · 2025Article
- Antifungal Prophylaxis and Treatment of Breakthrough Invasive Fungal Diseases in High-Risk Hematology Patients: A Prospective Observational Multicenter Study.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Approaches for posaconazole therapeutic drug monitoring and their clinical benefits.European journal of clinical pharmacology · 2024Review
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Factors influencing voriconazole plasma level in intensive care patients.JAC-antimicrobial resistance · 2024Article
- Voriconazole: a review of adjustment programs guided by therapeutic drug monitoring.Frontiers in pharmacology · 2024Review
- Lady Windermere syndrome with haemoptysis: suspected pulmonary aspergilloma and MAC pulmonary disease.BMJ case reports · 2023Article
- Antifungal Therapeutic Drug Monitoring Practices: Results of an Emerging Infections Network Survey.Open forum infectious diseases · 2023Article
- Mortality in ICU Patients with COVID-19-Associated Pulmonary Aspergillosis.Journal of fungi (Basel, Switzerland) · 2023Review
- The Fragile Patient: Considerations in the Management of Invasive Mould Infections (IMIs) in India.Cureus · 2023Review
- A Comprehensive Overview of the Antibiotics Approved in the Last Two Decades: Retrospects and Prospects.Molecules (Basel, Switzerland) · 2023Review
- Nanotechnology-Based Approaches for Voriconazole Delivery Applied to Invasive Fungal Infections.Pharmaceutics · 2023Review
- The impact of gene polymorphism and hepatic insufficiency on voriconazole dose adjustment in invasive fungal infection individuals.Frontiers in genetics · 2023Review
- Electromembrane Extraction of Posaconazole for Matrix-Assisted Laser Desorption/Ionization Mass Spectrometric Detection.Membranes · 2022Article
- Interaction between posaconazole and flucloxacillin in a lung transplant patient: decrease in plasma exposure of posaconazole and possible undertreatment of invasive aspergillosis: case report.BMC pulmonary medicine · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTherapeutic drug monitoring (TDM) aims to minimize the clinical impact of posaconazole and voriconazole pharmacokinetic variability. However, its benefits on clinical outcomes are still being defined. Additionally, TDM data are limited for posaconazole IV and delayed-release tablet formulations among specific patient populations, including critically ill. The aim of this study was to determine the percentage of therapeutic posaconazole and voriconazole drug levels across all formulations in a real-world clinical setting and elucidate factors affecting attainment of target concentrations.
methodsThis study was a retrospective cohort study conducted at the University of Colorado Hospital between September 2006 and June 2015 that evaluated patients who received posaconazole or voriconazole TDM as part of routine care.
resultsVoriconazole (n = 250) and posaconazole (n = 100) levels were analyzed from 151 patients. Of these, 54% of voriconazole and 69% of posaconazole levels were therapeutic. For posaconazole, 14/38 (37%), 28/29 (97%) and 27/33 (82%) levels were therapeutic for the oral suspension, IV, and delayed-release tablet, respectively. Intravenous and delayed-release tablet posaconazole were 20 fold (p < 0.01) and sevenfold (p = 0.002) more likely than the oral suspension to achieve a therapeutic level. Subsequent levels were more likely to be therapeutic after dose adjustments (OR 3.31; 95% CI 1.3-8.6; p = 0.02), regardless of timing of initial non-therapeutic level. In a multivariable logistic regression analysis, no characteristics were independently predictive of therapeutic voriconazole levels and only absence of H2RA/PPI use was independently predictive of therapeutic posaconazole levels. There was no correlation between survival and therapeutic drug levels for either voriconazole (p = 0.67) or posaconazole (p = 0.50).
conclusionsA high percentage of drug levels did not achieve TDM targets for voriconazole and posaconazole oral suspension, supporting the need for routine TDM for those formulations. The utility of TDM for the IV and delayed-release tablet formulations of posaconazole is less apparent.
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Registered trials
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