Gómez-López Alicia
Mycology Reference and Research Laboratory, Spain
Title: Triazoles therapeutic drug monitoring: from recommendation to applicability
Biography
Biography: Gómez-López Alicia
Abstract
The past three decades have seen a considerable expansion in antifungal drug research that led to the clinical development of antifungal agents with different pharmacologic properties. The new antifungal triazoles (fluconazole FCZ, voriconazole VCZ, itraconazole ICZ, posaconazole PCZ and isavuconazole ISvZ) are widely used for the management of invasive fungal infections (IFI). With the exception of fluconazole, these triazoles exhibit significant inter- and intrapatient pharmacokinetic variability and are associated to multiple drug interactions. Thus, unexpected blood concentrations often need to be evaluated in patients treated with them, to prevent treatment failure or toxicity. A large number of recent studies suggested that the efficacy and tolerance of azoles can be increased through TDM. Measuring blood concentrations of these antifungals and their metabolites could be used for quick identification of patients with impaired metabolism, a suitable strategy to improve effectiveness of this type of treatment. So, to facilitate dosage adjustment, easy, accurate and precise TDM methods need to be routinely used.
Objective: The aim of the study was to describe systemic azoles pharmacokinetic in a collection of clinical samples using a validated HPLC-PDA assay. The method also allows the simultaneous quantification of triazoles and some of their major metabolites (voriconazole N-oxide VCZ N-oxide, and hidroxy-itraconazole OH-ICZ) in the same run.