{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:07:11Z","timestamp":1784714831366,"version":"3.55.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"French Society of Medical Mycology"},{"name":"French Society of Pharmacology and Therapeutics"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Treating Candida spp. urinary tract infections (UTIs) are challenging when isolates have reduced susceptibility to fluconazole. Voriconazole may be a therapeutic alternative despite its low urinary excretion as an unchanged compound.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify voriconazole and its main metabolite, voriconazole N-oxide, in urine and plasma, determine minimum inhibitory concentrations (MICs) of voriconazole and voriconazole N-oxide, and assess the antifungal activity of urine from voriconazole-treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty patients receiving oral voriconazole were prospectively included. Voriconazole and voriconazole N-oxide concentrations in urine (12-h urine volume) and plasma were measured by liquid chromatography-tandem mass spectrometry. MICs were determined by broth microdilution according to EUCAST guidelines. Urinary antifungal activity was assessed using a disk diffusion bioassay, including against N. glabratus. A pharmacokinetic\/pharmacodynamic target concentration\/MIC &amp;gt;1 in urine was defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median voriconazole urinary concentration was 1.9\u2005mg\/L [1.1\u20133.1], similar to plasma trough concentration (2.2\u2005mg\/L) and positively correlated (R2\u200a=\u200a0.82). Voriconazole N-oxide urinary concentrations (median 20.4\u2005mg\/L) were substantially higher than plasma trough concentrations (median 2.1\u2005mg\/L). Voriconazole MICs ranged from 0.155 to 0.75\u2005mg\/L, while voriconazole N-oxide MICs were 32\u201348\u2005mg\/L for reduced susceptibility to fluconazole isolates. Urine with voriconazole concentrations above 3\u2005mg\/L was more likely to inhibit N. glabratus. The median urinary voriconazole concentration\/MIC ratio of 4.75 supports potential clinical efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Voriconazole can achieve therapeutically relevant urinary concentrations for treating UTIs with reduced susceptibility to fluconazole. Therapeutic drug monitoring may facilitate individualized dosing and optimize treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag231","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:59:57Z","timestamp":1784714397000},"source":"Crossref","is-referenced-by-count":0,"title":["Can pharmacokinetic\/pharmacodynamic targets be achieved with voriconazole in the treatment of urinary tract infections caused by\n                    <i>Candida<\/i>\n                    spp. with reduced susceptibility to fluconazole?"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4527-0958","authenticated-orcid":false,"given":"Christelle","family":"Boglione-Kerrien","sequence":"first","affiliation":[{"name":"Laboratory of Biological Pharmacology CHU Rennes, , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0908-3629","authenticated-orcid":false,"given":"Florian","family":"Lemaitre","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Pharmacology CHU Rennes, , Rennes ,","place":["France"]},{"name":"Univ Rennes, CHU de Rennes, Inserm, Irset (Institut de recherche en sant\u00e9, environnement et travail) - UMR_S 1085 , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5846-3847","authenticated-orcid":false,"given":"Elodie","family":"Gautier-Veyret","sequence":"additional","affiliation":[{"name":"Univ. 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Grenoble Alpes, CNRS, UMR 5525, CHU Grenoble Alpes, VetAgro Sup, Grenoble INP, TIMC , Grenoble ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Botterel","sequence":"additional","affiliation":[{"name":"Unit of Parasitology- Mycology, Henri Mondor University Hospital, APHP , Creteil ,","place":["France"]},{"name":"Dynamyc team, University Paris Est Creteil (UPEC), ANSES , Creteil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Morcet","sequence":"additional","affiliation":[{"name":"Inserm, CIC-P 1414 Clinical Investigation Centre , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Le Bot","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Rennes University Hospital , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6595-8154","authenticated-orcid":false,"given":"Marie-Cl\u00e9mence","family":"Verdier","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Pharmacology CHU Rennes, , Rennes ,","place":["France"]},{"name":"Univ Rennes, CHU de Rennes, Inserm, Irset (Institut de recherche en sant\u00e9, environnement et travail) - UMR_S 1085 , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-5607","authenticated-orcid":false,"given":"Jean-Pierre","family":"Gangneux","sequence":"additional","affiliation":[{"name":"Univ Rennes, CHU de Rennes, Inserm, Irset (Institut de recherche en sant\u00e9, environnement et travail) - UMR_S 1085 , Rennes ,","place":["France"]},{"name":"CHU Rennes, Laboratory of Parasitology and Medical Mycology, European Confederation of Medical Mycology (ECMM) Excellence Center, Centre National de R\u00e9f\u00e9rence Aspergilloses Chroniques , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Guegan","sequence":"additional","affiliation":[{"name":"Univ Rennes, CHU de Rennes, Inserm, Irset (Institut de recherche en sant\u00e9, environnement et travail) - UMR_S 1085 , Rennes ,","place":["France"]},{"name":"CHU Rennes, Laboratory of Parasitology and Medical Mycology, European Confederation of Medical Mycology (ECMM) Excellence Center, Centre National de R\u00e9f\u00e9rence Aspergilloses Chroniques , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"2026072205595103700_dkag231-B1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1007\/s10096-007-0427-9","article-title":"Clinician response to Candida organisms in the urine of patients attending hospital","volume":"27","author":"Chen","year":"2008","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2026072205595103700_dkag231-B2","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/j.purol.2011.02.004","article-title":"Recommendations of the Infectious Disease Committee of the French Association of Urology. 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