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Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis

Voriconazole is one of the most used antifungal azoles against pulmonary aspergillosis. Therapeutic drug monitoring (TDM) of the voriconazole concentration in plasma is recommended in clinical practice guidelines to prevent treatment failure and toxicity. The aim of this study was to evaluate the fe...

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Autores principales: Sarfati, Sacha, Wils, Julien, Lambert, Timothée, Mory, Céline, Imbert, Laurent, Gargala, Gilles, Morisse-Pradier, Hélène, Lamoureux, Fabien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9414625/
https://www.ncbi.nlm.nih.gov/pubmed/36015224
http://dx.doi.org/10.3390/pharmaceutics14081598
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author Sarfati, Sacha
Wils, Julien
Lambert, Timothée
Mory, Céline
Imbert, Laurent
Gargala, Gilles
Morisse-Pradier, Hélène
Lamoureux, Fabien
author_facet Sarfati, Sacha
Wils, Julien
Lambert, Timothée
Mory, Céline
Imbert, Laurent
Gargala, Gilles
Morisse-Pradier, Hélène
Lamoureux, Fabien
author_sort Sarfati, Sacha
collection PubMed
description Voriconazole is one of the most used antifungal azoles against pulmonary aspergillosis. Therapeutic drug monitoring (TDM) of the voriconazole concentration in plasma is recommended in clinical practice guidelines to prevent treatment failure and toxicity. The aim of this study was to evaluate the feasibility and utility of TDM of the voriconazole concentration in the sputum of patients treated for pulmonary aspergillosis. Fifty sputum and 31 plasma samples were analysed with high-performance tandem mass spectrometry (HPLC-MS/MS) in 24 patients included in the study. The voriconazole concentration was simultaneously assessed in the plasma and sputum in 22 samples. The correlation between the sputum and plasma levels was estimated with a univariate linear regression model, and the observed R(2) was 0.86. We determined the following equation, C(sputum) = 0.45 (C(plasma)) + 0.21, which could predict the voriconazole concentration in plasma from sputum. TDM of the voriconazole concentration in sputum is an easy, non-invasive and accurate method with which to evaluate voriconazole exposure in patients with pulmonary aspergillosis.
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spelling pubmed-94146252022-08-27 Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis Sarfati, Sacha Wils, Julien Lambert, Timothée Mory, Céline Imbert, Laurent Gargala, Gilles Morisse-Pradier, Hélène Lamoureux, Fabien Pharmaceutics Communication Voriconazole is one of the most used antifungal azoles against pulmonary aspergillosis. Therapeutic drug monitoring (TDM) of the voriconazole concentration in plasma is recommended in clinical practice guidelines to prevent treatment failure and toxicity. The aim of this study was to evaluate the feasibility and utility of TDM of the voriconazole concentration in the sputum of patients treated for pulmonary aspergillosis. Fifty sputum and 31 plasma samples were analysed with high-performance tandem mass spectrometry (HPLC-MS/MS) in 24 patients included in the study. The voriconazole concentration was simultaneously assessed in the plasma and sputum in 22 samples. The correlation between the sputum and plasma levels was estimated with a univariate linear regression model, and the observed R(2) was 0.86. We determined the following equation, C(sputum) = 0.45 (C(plasma)) + 0.21, which could predict the voriconazole concentration in plasma from sputum. TDM of the voriconazole concentration in sputum is an easy, non-invasive and accurate method with which to evaluate voriconazole exposure in patients with pulmonary aspergillosis. MDPI 2022-07-30 /pmc/articles/PMC9414625/ /pubmed/36015224 http://dx.doi.org/10.3390/pharmaceutics14081598 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Sarfati, Sacha
Wils, Julien
Lambert, Timothée
Mory, Céline
Imbert, Laurent
Gargala, Gilles
Morisse-Pradier, Hélène
Lamoureux, Fabien
Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis
title Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis
title_full Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis
title_fullStr Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis
title_full_unstemmed Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis
title_short Therapeutic Drug Monitoring of Sputum Voriconazole in Pulmonary Aspergillosis
title_sort therapeutic drug monitoring of sputum voriconazole in pulmonary aspergillosis
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9414625/
https://www.ncbi.nlm.nih.gov/pubmed/36015224
http://dx.doi.org/10.3390/pharmaceutics14081598
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