ArticleInfectious diseases and therapy2020
Therapeutic Drug Monitoring of Antifungal Drugs: Another Tool to Improve Patient Outcome?
Article in Infectious diseases and therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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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
18 citing papers in PubMed, 39 citations in OpenAlex.
- The equity gap in precision dosing: a cross-sectional analysis of hospital-wide antimicrobial therapeutic drug monitoring implementation.Frontiers in public health · 2026Article
- Management of Intra-Abdominal Candidiasis in Intensive Care Setting: A Narrative Review.Journal of fungi (Basel, Switzerland) · 2025Review
- Therapeutic drug monitoring of mycophenolic acid and azole antifungals on two distinct LC-MS/MS instruments.Journal of mass spectrometry and advances in the clinical lab · 2024Article
- Review
- Laboratory and clinical management capacity for invasive fungal infections: the Italian landscape.Infection · 2024Article
- Antifungals: From Pharmacokinetics to Clinical Practice.Antibiotics (Basel, Switzerland) · 2023Review
- Population Pharmacokinetics of Isavuconazole in Critical Care Patients with COVID-19-Associated Pulmonary Aspergillosis and Monte Carlo Simulations of High Off-Label Doses.Journal of fungi (Basel, Switzerland) · 2023Article
- Characterization of the interferences of systemic azole antifungal drugs with adrenal steroid biosynthesis using H295R cells and enzyme activity assays.Current research in toxicology · 2023Article
- Assessing Differences between Clinical Isolates ofPathogens (Basel, Switzerland) · 2022Article
- Repurposing Antifungals for Host-Directed Antiviral Therapy?Pharmaceuticals (Basel, Switzerland) · 2022Review
- Therapeutic drug monitoring practices of anti-infectives: An Asia-wide cross-sectional survey.Frontiers in pharmacology · 2022Article
- Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study.Journal of fungi (Basel, Switzerland) · 2021Article
- Model-Optimized Fluconazole Dose Selection for Critically Ill Patients Improves Early Pharmacodynamic Target Attainment without the Need for Therapeutic Drug Monitoring.Antimicrobial agents and chemotherapy · 2021Article
- Application of Population Pharmacokinetic Analysis to Characterize CYP2C19 Mediated Metabolic Mechanism of Voriconazole and Support Dose Optimization.Frontiers in pharmacology · 2021Article
- Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients.PloS one · 2021Article
- Impact of Loading Dose of Caspofungin in Pharmacokinetic-Pharmacodynamic Target Attainment for Severe Candidiasis Infections in Patients in Intensive Care Units: the CASPOLOAD Study.Antimicrobial agents and chemotherapy · 2020Article
- Article
- Improving management and antimicrobial stewardship for bacterial and fungal infections in hospitalized patients with COVID-19.Therapeutic advances in infectious diseaseReview
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionThis study aimed to examine the relationship among adequate dose, serum concentration and clinical outcome in a non-selected group of hospitalized patients receiving antifungals.
methodsProspective cross-sectional study performed between March 2015 and June 2015. Dosage of antifungals was considered adequate according to the IDSA guidelines, whereas trough serum concentrations (determined with HPLC) were considered adequate as follows: fluconazole > 11 µg/ml, echinocandins > 1 µg/ml, voriconazole 1-5.5 µg/ml and posaconazole > 0.7 µg/ml.
resultsDuring the study period, 84 patients (65.4% male, 59.6 years) received antifungals for prophylaxis (40.4%), targeted (31.0%) and empirical therapy (28.6%). The most frequent drug was micafungin (28/84; 33.3%) followed by fluconazole (23/84; 27.4%), voriconazole (15/84; 17.9%), anidulafungin (8/84; 9.5%), posaconazole (7/84; 8.3%) and caspofungin (3/84; 3.6%). Considerable interindividual variability was observed for all antifungals with a large proportion of the patients (64.3%) not attaining adequate trough serum concentrations, despite receiving an adequate antifungal dose. Attaining the on-target serum antifungal level was significantly associated with a favorable clinical outcome (OR = 0.02; 95% CI 0.01-0.64; p = 0.03), whereas the administration of an adequate antifungal dosage was not.
conclusionsWith the standard antifungal dosage, a considerable proportion of patients have low drug concentrations, which are associated with poor clinical outcome.
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