지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2014.1
- 수록면
- 9 - 21 (13page)
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Purpose: To determine the clinical significance of voriconazole therapeutic drug monitoring (TDM) in the pediatric population.
Methods: Twenty-eight patients with invasive fungal infections administered with voriconazole from July 2010 to June 2012were investigated retrospectively. Fourteen received TDM, and 143 trough concentrations were analyzed. All 28 patientswere assessed for adverse events and treatment response six weeks into treatment, and at the end.
Results: Out of 143 samples, 53.1% were within therapeutic range (1.0-5.5 mg/L). Patients administered with the same loading(6 mg/kg/dose) and maintenance (4 mg/kg/dose) dosages prior to initial TDM showed highly variable drug levels. Adverseevents occurred in 9 of 14 patients (64.3%) in both the TDM and non-TDM group. In the TDM group, voriconazole-relatedencephalopathy (n=2, 14.3%) and aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation (n=8, 57.1%) occurred with serum levels in the toxic range (>5.5 mg/L), whereas blurred-vision (n=2, 14.3%) occurred within thetherapeutic range (1.18 mg/L and 3.9 mg/L). The frequency of voriconazole discontinuation due to adverse events waslower in the TDM group (0.0% vs. 18.2%, P =0.481). Overall, 57.2% of the patients in the TDM group versus 14.3% in thenon-TDM group showed clinical response after 6 weeks (P =0.055), whereas 21.4% in the TDM group versus 14.3% in thenon-TDM group showed response at final outcome (P =0.664). In the TDM group, >67.0% of the serum levels were withintherapeutic range for the first 6 weeks; however 45.5% were within therapeutic range for the entire duration.
Conclusion: Routine TDM is recommended for optimizing the therapeutic effects of voriconazole.
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참고문헌 (23)
참고문헌 신청
/ / National Cancer Institute
Ascioglu S / 2002 / Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international cons
Ashley ESD / 2006 / Pharmacology of systemic antifungal agents / Clin Infect Dis 43 : S28 ~ S39
Choi SH / 2013 / Importance of voriconazole therapeutic drug monitoring in pediatric cancer patients with invasive aspergillosis / Pediatr Blood Cancer 60 : 82 ~ 87
De Pauw B / 2008 / Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative G
Ascioglu S / 2002 / Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international cons
Ashley ESD / 2006 / Pharmacology of systemic antifungal agents / Clin Infect Dis 43 : S28 ~ S39
Choi SH / 2013 / Importance of voriconazole therapeutic drug monitoring in pediatric cancer patients with invasive aspergillosis / Pediatr Blood Cancer 60 : 82 ~ 87
De Pauw B / 2008 / Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative G
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