Effect of inflammation on voriconazole levels in patients with invasive pulmonary aspergillosis.

IF 1.4 4区医学 Q4 INFECTIOUS DISEASES

Journal of Infection in Developing Countries Pub Date : 2024-10-31 DOI:10.3855/jidc.19290

Pinar Bakir Ekinci, Emre Kara, Ahmet G Er, Asli Pinar, Ahmet C Inkaya, Kutay Demirkan, Gokhan Metan, Omrum Uzun

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引用次数: 0

Abstract

Introduction: Voriconazole (VCZ) serum concentrations may be affected by many factors, such as drug-drug interactions, liver dysfunction, genetic polymorphism, and inflammation. This study aimed to determine the relationship between VCZ measured trough plasma levels and C-reactive protein levels in patients with coronavirus disease 2019 (COVID-19)-associated aspergillosis (CAPA) and invasive pulmonary aspergillosis (IPA).

Methodology: Patients who were > 18 years of age, received VCZ treatment for IPA or CAPA in our hospital between March 2020 and April 2021, and had their VCZ level monitored, were included in this retrospective study.

Results: A total of 85 patients (35 diagnosed with CAPA) were included in this study. Forty-three patients (50.6%) had VCZ levels in the therapeutic range, 4 (4.7%) were sub-therapeutic, and 38 (44.7%) were supra-therapeutic. Inflammatory markers were significantly higher in patients with supra-therapeutic levels (p < 0.05). Supra-therapeutic levels and VCZ-related adverse effects were significantly more frequent in CAPA patients than in IPA patients (p = 0.011 and p = 0.002, respectively).

Conclusions: Patients diagnosed with CAPA were more prone to adverse effects and supra-therapeutic VCZ levels. More frequent therapeutic drug monitoring is recommended in this patient population.

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炎症对侵袭性肺曲霉病患者伏立康唑水平的影响。

伏立康唑（Voriconazole， VCZ）的血药浓度可能受到多种因素的影响，如药物-药物相互作用、肝功能障碍、基因多态性、炎症等。本研究旨在确定2019冠状病毒病（COVID-19）相关曲霉病（CAPA）和侵袭性肺曲霉病（IPA）患者血浆中VCZ测量值与c反应蛋白水平的关系。方法：选取2020年3月至2021年4月期间在我院接受IPA或CAPA VCZ治疗并监测VCZ水平的18岁至18岁患者为研究对象。结果：本研究共纳入85例CAPA患者，其中35例确诊为CAPA。43例（50.6%）患者VCZ水平在治疗范围内，4例（4.7%）处于亚治疗状态，38例（44.7%）处于超治疗状态。超治疗水平组炎症指标明显升高（p < 0.05）。超治疗水平和vcz相关不良反应在CAPA患者中明显高于IPA患者（p = 0.011和p = 0.002）。结论：诊断为CAPA的患者更容易出现不良反应，且VCZ水平高于治疗水平。建议对这类患者进行更频繁的治疗药物监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection in Developing Countries INFECTIOUS DISEASES-

CiteScore

3.70

自引率

5.30%

发文量

239

审稿时长

4-8 weeks

期刊介绍： The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries. JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.