Utility of triazole antifungal therapeutic drug monitoring: Insights from the Society of Infectious Diseases Pharmacists

Author:

McCreary Erin K.1ORCID,Davis Matthew R.2ORCID,Narayanan Navaneeth3ORCID,Andes David R.4ORCID,Cattaneo Dario5ORCID,Christian Robbie6,Lewis Russell E.7ORCID,Watt Kevin M.8ORCID,Wiederhold Nathan P.9ORCID,Johnson Melissa D.10ORCID

Affiliation:

1. Division of Infectious Diseases, Department of Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA

2. Infectious Disease Connect, Inc. Pittsburgh Pennsylvania USA

3. Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy Rutgers University Piscataway New Jersey USA

4. Departments of Medicine and Medical Microbiology & Immunology University of Wisconsin‐Madison Madison Wisconsin USA

5. Unit of Clinical Pharmacology, Department of Laboratory Medicine Luigi Sacco University Hospital Milan Italy

6. Department of Pharmacy Veterans Affairs Northeast Ohio Healthcare System Cleveland Ohio USA

7. Department of Molecular Medicine University of Padua Padua Italy

8. Division of Pediatric Clinical Pharmacology and Division of Critical Care University of Utah Salt Lake City Utah USA

9. Department of Pathology and Laboratory Medicine, Fungus Testing Laboratory University of Texas Health Science Center at San Antonio San Antonio Texas USA

10. Division of Infectious Diseases, Department of Medicine Duke University Medical Center Durham North Carolina USA

Abstract

AbstractTriazole antifungals (i.e., fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) are commonly used in clinical practice to prevent or treat invasive fungal infections. Most triazole antifungals require therapeutic drug monitoring (TDM) due to highly variable pharmacokinetics, known drug interactions, and established relationships between exposure and response. On behalf of the Society of Infectious Diseases Pharmacists (SIDP), this insight describes the pharmacokinetic principles and pharmacodynamic targets of commonly used triazole antifungals and provides the rationale for utility of TDM within each agent.

Publisher

Wiley

Subject

Pharmacology (medical)

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