Voriconazole Restriction in Addition to Therapeutic Drug Monitoring (TDM) Protocol Results in Optimized Dosing
Methods: All adult inpatients receiving therapeutic voriconazole for either presumed or documented invasive fungal infections, with a serum trough concentration obtained between 10/20/2012-7/23/2013 were included in this analysis. Patients that received voriconazole for prophylaxis were excluded.
Results: Twenty-five adult inpatients receiving therapeutic VRC had a serum trough concentration obtained. 80% of patients were found to have a TTC with a median trough of 4.3 mcg/dL. Among patients that received a loading dose (N=19), 89.4% of patients achieved a TTC. Of those that did not receive a loading dose (N=6), only 50% achieved a TTC. Trough concentrations were obtained on day 5 of therapy (median).
Conclusion: Following the implementation of a VRC TDM protocol in addition to concerted efforts by ASP in ensuring safe and appropriate utilization, rate of success in achieving TTC increased by 36-45.4%. Patients receiving a loading dose were more likely to achieve TTC on day 5 of therapy.
M. Vicente, None
E. Landon, None
J. Pisano, Pfizer: Grant Investigator, Research grant
A. H. Bartlett, None