In:
Mycoses, Wiley, Vol. 59, No. 10 ( 2016-10), p. 644-651
Abstract:
Because of concerns about accumulation of cyclodextrin, oral voriconazole is recommended for patients with renal impairment. However, intravenous voriconazole may occasionally be imperative in critically ill patients with life‐threatening invasive aspergillosis. We investigated the clinical effects of intravenous voriconazole formulated with sulfobutylether β‐cyclodextrin ( SBECD ) in patients with renal impairment. A prospective observational study was conducted on 25 adult patients with haematological malignancies who were treated with intravenous voriconazole for invasive aspergillosis. Among them, seven patients had a baseline creatinine clearance (CrCl) 〈 50 ml min −1 (case). Although voriconazole trough concentrations were significantly higher in cases (5.84 mg l −1 ) than controls (2.28 mg l −1 ), the proportion of concentrations within the target range did not differ between two groups (4/7 and 12/18, respectively; P = 0.658). The frequency of severe adverse events in cases (3/7) was comparable to that of controls (4/18; P = 0.355). No patients showed significant deterioration in renal function after the voriconazole therapy even in patients with renal impairment. Although CrCl 〈 50 ml min −1 was associated with higher voriconazole concentrations, its clinical impact remains unclear. SBECD ‐formulated intravenous voriconazole did not lead to a higher incidence of severe adverse events including nephrotoxicity in haematological patients with CrCl 〈 50 ml min −1 .
Type of Medium:
Online Resource
ISSN:
0933-7407
,
1439-0507
DOI:
10.1111/myc.2016.59.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2020780-3
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