Evaluating the impact of infectious disease pharmacy services on voriconazole dose individualization in pediatric oncology.

Personalized medicine Pub Date : 2025-12-01 Epub Date: 2025-12-02 DOI:10.1080/17410541.2025.2592525

Mai Samy Azab, Dalia Makhlouf, Omneya Ahmed, Omneya Hassanain, Lobna Shalaby, Mohamed Nagy

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Abstract

Background: The application of personalized medication management for Voriconazole(VCZ), such as therapeutic drug monitoring (TDM), is the gold standard for attaining therapeutic goals in invasive fungal infections. Infectious disease (ID) pharmacists are the best for ensuring the recommendations are properly implemented.

Aim: To assess the adherence of healthcare teams to VCZ dose individualization and the impact of the ID pharmacy team.

Method: This study included pediatric oncology patients who received VCZ in the inpatient department and had VCZ TDM level measurements for 3 months (from January to March 2019) and after implementing the (ID) pharmacy service during the same months in two different years (2020, 2021).

Results: This study included 989 patients who received VCZ; only 588/989 patients (59.5%) had VCZ TDM levels. Dose individualization was required for 62.6% (849/1357) levels, while 37.4% (508/1357) levels were in the therapeutic range. The overall compliance rate with the TDM recommendations was 92.9% (789/849). Additionally, there was a significant increase in VCZ dose individualization adherence after ID pharmacy implementation (88.6% (210/237) vs. 94.6% (579/612), p = 0.002). The rate of doctor acceptance of the ID pharmacist intervention was 94.7%.

Conclusion: ID pharmacists' contributions are crucial and can increase clinicians' adherence to individualized dose recommendations.

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评估感染性疾病药房服务对小儿肿瘤科伏立康唑剂量个体化的影响。

背景：伏立康唑（VCZ）个体化用药管理的应用，如治疗药物监测（TDM），是实现侵袭性真菌感染治疗目标的金标准。传染病（ID）药剂师是确保建议得到适当实施的最佳人选。目的：评估医疗团队对VCZ剂量个体化的依从性及ID药房团队的影响。方法：本研究包括在住房部接受VCZ治疗并在3个月内（2019年1月至3月）测量VCZ TDM水平的儿科肿瘤患者，以及在不同年份（2020年、2021年）的相同月份实施（ID）药房服务后的患者。结果：本研究纳入989例接受VCZ治疗的患者；989例患者中仅有588例（59.5%）达到VCZ TDM水平。62.6%（849/1357）水平需要剂量个体化，37.4%（508/1357）水平在治疗范围内。TDM建议的总体依从率为92.9%（789/849）。此外，实施ID药房后，VCZ剂量个体化依从性显著增加（88.6%（210/237）对94.6% (579/612),p = 0.002）。医师对ID药师干预的接受率为94.7%。结论：ID药师的贡献至关重要，可以提高临床医生对个体化剂量建议的依从性。

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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Personalized medicine

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