{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:36:46Z","timestamp":1792427806523,"version":"4.5.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2012,9,1]],"date-time":"2012-09-01T00:00:00Z","timestamp":1346457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Voriconazole is a first-line agent in the treatment of many invasive fungal infections and is known to display highly variable pharmacokinetics. Previous studies of voriconazole therapeutic drug monitoring (TDM) have suggested concentration monitoring to be clinically useful but have been limited by small patient samples at a single institution. This multicenter retrospective study aimed to investigate relationships between voriconazole concentration and clinical outcomes and adverse events and to assess clinical factors and drug interactions that may affect voriconazole concentration. Medical records were reviewed for patients who received voriconazole and had at least 1 concentration measured at seven hospitals in Australia. The study included 201 patients with 783 voriconazole trough concentrations. Voriconazole concentrations of &lt;1.7 mg\/liter were associated with a significantly greater incidence of treatment failure (19\/74 patients [26%]) than concentrations of \u22651.7 mg\/liter (6\/89 patients [7%]) (\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.01). Neurotoxic adverse events (visual and auditory hallucinations) occurred more frequently at voriconazole concentrations of &gt;5 mg\/liter (10\/31 patients [32%]) than at concentrations of \u22645 mg\/liter (2\/170 patients [1.2%]) (\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.01). Multiple regression analysis of voriconazole concentration identified associations between increasing patient weight, oral administration of voriconazole, and coadministration of phenytoin or rifampin and significantly reduced concentrations, and associations between increasing patient age and coadministration of proton pump inhibitors and increased concentrations. Coadministration of glucocorticoids was found to significantly reduce voriconazole concentrations, inferring a previously unreported drug interaction between glucocorticoids and voriconazole.\n          <\/jats:p>","DOI":"10.1128\/aac.00626-12","type":"journal-article","created":{"date-parts":[[2012,7,3]],"date-time":"2012-07-03T02:37:25Z","timestamp":1341283045000},"page":"4793-4799","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":267,"title":["Multicenter Study of Voriconazole Pharmacokinetics and Therapeutic Drug Monitoring"],"prefix":"10.1128","volume":"56","author":[{"given":"Michael J.","family":"Dolton","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy, University of Sydney, Camperdown, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Ray","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology, SydPath, St. Vincent's Hospital, Darlinghurst, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C.-A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases &amp; Microbiology and the University of Sydney, Westmead Hospital, Westmead, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kingsley","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Westmead Hospital, Westmead, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa G.","family":"Pont","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, University of Sydney, Camperdown, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, University of Sydney, Camperdown, Australia"},{"name":"Centre For Education and Research on Ageing, Concord Repatriation General Hospital, Concord, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.10.3165-3169.2003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00705-08"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"769","DOI":"10.2165\/00002018-200629090-00002","article-title":"Pharmacokinetic drug interaction profiles of proton pump inhibitors","volume":"29","author":"Blume H","year":"2006","unstructured":"BlumeH DonathF WarnkeA SchugBS. 2006. Pharmacokinetic drug interaction profiles of proton pump inhibitors. Drug Saf. 29:769\u2013784.","journal-title":"Drug Saf."},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1086\/424662","article-title":"Adverse reactions to voriconazole","volume":"39","author":"Boyd AE","year":"2004","unstructured":"BoydAE . 2004. Adverse reactions to voriconazole. Clin. Infect. Dis. 39:1241\u20131244.","journal-title":"Clin. Infect. Dis."},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1124\/mol.64.2.316","article-title":"Identification of constitutive androstane receptor and glucocorticoid receptor binding sites in the CYP2C19 promoter","volume":"64","author":"Chen Y","year":"2003","unstructured":"ChenY FergusonSS NegishiM GoldsteinJA. 2003. Identification of constitutive androstane receptor and glucocorticoid receptor binding sites in the CYP2C19 promoter. Mol. Pharmacol. 64:316\u2013324.","journal-title":"Mol. 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Monitoring plasma voriconazole levels may be necessary to avoid subtherapeutic levels in hematopoietic stem cell transplant recipients. Cancer 109:1532\u20131535.","journal-title":"Cancer"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705754"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01083-10"},{"key":"e_1_3_2_33_2","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1007\/s12185-009-0296-3","article-title":"Monitoring trough concentration of voriconazole is important to ensure successful antifungal therapy and to avoid hepatic damage in patients with hematological disorders","volume":"89","author":"Ueda K","year":"2009","unstructured":"UedaK . 2009. Monitoring trough concentration of voriconazole is important to ensure successful antifungal therapy and to avoid hepatic damage in patients with hematological disorders. Int. J. Hematol. 89:592\u2013599.","journal-title":"Int. J. 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