SynthesisCritical care (London, England)2025
Factors affecting voriconazole pharmacokinetic variability in critically ill patients: a systematic review.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed.
- Therapeutic Failure in Invasive Fungal Infections: Beyond Antifungal Resistance-A Narrative Review.Journal of fungi (Basel, Switzerland) · 2026Review
- Factors affecting voriconazole pharmacokinetic variability in critically ill patients: a systematic review.Critical care (London, England) · 2026Article
- RE: Factors affecting voriconazole pharmacokinetic variability in critically ill patients: a systematic review.Critical care (London, England) · 2026Article
- Voriconazole therapeutic drug monitoring and safety in HIV-infected patients with invasive fungal disease.Frontiers in pharmacology · 2026Article
- The pharmacokinetics and pharmacogenomics of voriconazole in pediatric Saudi patients: advancing toward precision medicine.Frontiers in pharmacology · 2026Article
- Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe efficacy and toxicity of voriconazole, a broad-spectrum antifungal agent, are correlated with its trough concentration (C
methodsWe searched MEDLINE, Web of Science and Cochrane Library databases from inception through July 2025.
resultsThirty-one studies describing nine factors of variability were included. Liver dysfunction, high body mass index, high SOFA score and high inflammation status were associated with voriconazole overexposure, whereas the oral route of administration, renal replacement therapy and low body mass index were associated with voriconazole underexposure. The effects of extracorporeal membrane oxygenation and hypoalbuminemia on voriconazole exposure were unclear.
conclusionsA systematic dose adaptation is required for patients with liver dysfunction, and voriconazole dose calculation should not be based on total body weight, with an adjusted body weight a preferred alternative. Intravenous administration should be favoured in patients without severe renal dysfunction. Further research to define the benefit of an individualised dosing approach for voriconazole in ICU patients that combines pharmacokinetic modelling and machine learning, is warranted. Meanwhile, close therapeutic drug monitoring is needed for ICU patients, especially those with identified risk factors for under- or overexposure.
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