{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:45:01Z","timestamp":1789731901367,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22HA1004"],"award-info":[{"award-number":["22HA1004"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Although therapeutic drug monitoring (TDM) of voriconazole is performed in outpatients to prevent treatment failure and toxicity, whether TDM should be performed in all or only selected patients remains controversial. This study evaluated the association between voriconazole trough concentrations and clinical events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated the aggravation of clinical symptoms, incidence of hepatotoxicity and visual disturbances, change in co\u2010medications and interaction between voriconazole and co\u2010medications in outpatients receiving voriconazole between 2017 and 2021 in three facilities. Abnormal trough concentrations were defined as &lt;1.0\u00a0mg\/L (low group) and &gt;4.0\u00a0mg\/L (high group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 141 outpatients (578 concentration measurements) met the inclusion criteria (treatment, 37 patients, 131 values; prophylaxis, 104 patients, 447 values). The percentages of patients with abnormal concentrations were 29.0% and 31.5% in the treatment and prophylaxis groups, respectively. Abnormal concentrations showed 50% of the concentrations at the first measurement in both therapies. Aggravation of clinical symptoms was most frequently observed in the low treatment group (18.2%). Adverse events were most common in the high group for both therapies (treatment, hepatotoxicity 6.3%, visual disturbance 18.8%; prophylaxis, hepatotoxicity 27.9%). No differences were found in changes to co\u2010medications and drug interactions. In the prophylaxis group, prescription duration in the presence of clinical events tended to be longer than in their absence (47.4\u00a0\u00b1\u200923.4\u00a0days <jats:italic>vs<\/jats:italic> 39.7\u00a0\u00b1\u200921.9\u00a0days, <jats:italic>P<\/jats:italic>\u00a0=\u2009.1132).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We developed an algorithm based on clinical events for appropriate implementation of TDM in outpatients. However, future interventions based on this algorithm should be validated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16004","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T08:20:33Z","timestamp":1707294033000},"page":"1222-1230","source":"Crossref","is-referenced-by-count":11,"title":["Development of a therapeutic drug\u2010monitoring algorithm for outpatients receiving voriconazole: A multicentre retrospective study"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5272-9560","authenticated-orcid":false,"given":"Hideo","family":"Kato","sequence":"first","affiliation":[{"name":"Department of Pharmacy Mie University Hospital  Tsu Mie Japan"},{"name":"Department of Clinical Pharmaceutics, Division of Clinical Medical Science Mie University Graduate School of Medicine  Tsu Mie Japan"},{"name":"Department of Clinical Infectious Diseases Aichi Medical University  Nagakute Aichi 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