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Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients
Therapeutic drug monitoring (TDM) is essential for voriconazole to ensure optimal drug exposure, mainly in critically ill patients for whom voriconazole demonstrated a large variability. The study aimed at describing factors associated with trough voriconazole concentrations in critically ill patien...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612507/ https://www.ncbi.nlm.nih.gov/pubmed/34818379 http://dx.doi.org/10.1371/journal.pone.0260656 |
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author | Bienvenu, Anne-Lise Pradat, Pierre Plesa, Alexandra Leclerc, Vincent Piriou, Vincent Fellahi, Jean-Luc Argaud, Laurent Rimmelé, Thomas Menotti, Jean Aubrun, Frédéric Richard, Jean-Christophe Gagnieu, Marie-Claude Parant, François Chidiac, Christian Leboucher, Gilles Tod, Michel Goutelle, Sylvain |
author_facet | Bienvenu, Anne-Lise Pradat, Pierre Plesa, Alexandra Leclerc, Vincent Piriou, Vincent Fellahi, Jean-Luc Argaud, Laurent Rimmelé, Thomas Menotti, Jean Aubrun, Frédéric Richard, Jean-Christophe Gagnieu, Marie-Claude Parant, François Chidiac, Christian Leboucher, Gilles Tod, Michel Goutelle, Sylvain |
author_sort | Bienvenu, Anne-Lise |
collection | PubMed |
description | Therapeutic drug monitoring (TDM) is essential for voriconazole to ensure optimal drug exposure, mainly in critically ill patients for whom voriconazole demonstrated a large variability. The study aimed at describing factors associated with trough voriconazole concentrations in critically ill patients and evaluating the impact of voriconazole concentrations on adverse effects. A 2-year retrospective multicenter cohort study (NCT04502771) was conducted in six intensive care units. Adult patients who had at least one voriconazole TDM were included. Univariable and multivariable linear regression analyses were performed to identify predictors of voriconazole concentrations, and univariable logistic regression analysis, to study the relationship between voriconazole concentrations and adverse effects. During the 2-year study period, 70 patients were included. Optimal trough voriconazole concentrations were reported in 37 patients (52.8%), subtherapeutic in 20 (28.6%), and supratherapeutic in 13 (18.6%). Adverse effects were reported in six (8.6%) patients. SOFA score was identified as a factor associated with an increase in voriconazole concentration (p = 0.025), mainly in the group of patients who had SOFA score ≥ 10. Moreover, an increase in voriconazole concentration was shown to be a risk factor for occurrence of adverse effects (p = 0.011). In that respect, critically ill patients who received voriconazole treatment must benefit from a TDM, particularly if they have a SOFA score ≥ 10. Indeed, identifying patients who are overdosed will help to prevent voriconazole related adverse effects. This result is of utmost importance given the recognized COVID-19-associated pulmonary aspergillosis in ICU patients for whom voriconazole is among the recommended first-line treatment. |
format | Online Article Text |
id | pubmed-8612507 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-86125072021-11-25 Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients Bienvenu, Anne-Lise Pradat, Pierre Plesa, Alexandra Leclerc, Vincent Piriou, Vincent Fellahi, Jean-Luc Argaud, Laurent Rimmelé, Thomas Menotti, Jean Aubrun, Frédéric Richard, Jean-Christophe Gagnieu, Marie-Claude Parant, François Chidiac, Christian Leboucher, Gilles Tod, Michel Goutelle, Sylvain PLoS One Research Article Therapeutic drug monitoring (TDM) is essential for voriconazole to ensure optimal drug exposure, mainly in critically ill patients for whom voriconazole demonstrated a large variability. The study aimed at describing factors associated with trough voriconazole concentrations in critically ill patients and evaluating the impact of voriconazole concentrations on adverse effects. A 2-year retrospective multicenter cohort study (NCT04502771) was conducted in six intensive care units. Adult patients who had at least one voriconazole TDM were included. Univariable and multivariable linear regression analyses were performed to identify predictors of voriconazole concentrations, and univariable logistic regression analysis, to study the relationship between voriconazole concentrations and adverse effects. During the 2-year study period, 70 patients were included. Optimal trough voriconazole concentrations were reported in 37 patients (52.8%), subtherapeutic in 20 (28.6%), and supratherapeutic in 13 (18.6%). Adverse effects were reported in six (8.6%) patients. SOFA score was identified as a factor associated with an increase in voriconazole concentration (p = 0.025), mainly in the group of patients who had SOFA score ≥ 10. Moreover, an increase in voriconazole concentration was shown to be a risk factor for occurrence of adverse effects (p = 0.011). In that respect, critically ill patients who received voriconazole treatment must benefit from a TDM, particularly if they have a SOFA score ≥ 10. Indeed, identifying patients who are overdosed will help to prevent voriconazole related adverse effects. This result is of utmost importance given the recognized COVID-19-associated pulmonary aspergillosis in ICU patients for whom voriconazole is among the recommended first-line treatment. Public Library of Science 2021-11-24 /pmc/articles/PMC8612507/ /pubmed/34818379 http://dx.doi.org/10.1371/journal.pone.0260656 Text en © 2021 Bienvenu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Bienvenu, Anne-Lise Pradat, Pierre Plesa, Alexandra Leclerc, Vincent Piriou, Vincent Fellahi, Jean-Luc Argaud, Laurent Rimmelé, Thomas Menotti, Jean Aubrun, Frédéric Richard, Jean-Christophe Gagnieu, Marie-Claude Parant, François Chidiac, Christian Leboucher, Gilles Tod, Michel Goutelle, Sylvain Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients |
title | Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients |
title_full | Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients |
title_fullStr | Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients |
title_full_unstemmed | Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients |
title_short | Association between voriconazole exposure and Sequential Organ Failure Assessment (SOFA) score in critically ill patients |
title_sort | association between voriconazole exposure and sequential organ failure assessment (sofa) score in critically ill patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612507/ https://www.ncbi.nlm.nih.gov/pubmed/34818379 http://dx.doi.org/10.1371/journal.pone.0260656 |
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