{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:17:04Z","timestamp":1777681024764,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,9,29]],"date-time":"2018-09-29T00:00:00Z","timestamp":1538179200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Background: Fluconazole-associated liver injury is estimated to occur in &lt;10% of patients; however, effect of weight-based fluconazole dosing on liver injury is unknown. Furthermore, no studies have systematically applied the Drug-Induced Liver Injury Network (DILIN) Criteria to identify patients who may have drug-induced liver injury in an intensive care unit (ICU) setting. Objective: This study evaluated how often patients met DILIN criteria when receiving fluconazole daily doses of &lt;6 mg\/kg versus \u2a7e6 mg\/kg. Methods: This dual-center, retrospective cohort study was performed in hospitalized critically ill fluconazole recipients. We compared liver function tests (LFTs) upon fluconazole initiation to peak LFTs within 2 weeks after discontinuation using DILIN criteria. The primary objective was to evaluate the number of patients meeting DILIN criteria when receiving fluconazole daily doses of &lt;6 mg\/kg versus \u2a7e6 mg\/kg. Secondary objectives were to evaluate incidence of patients meeting DILIN criteria in patients with renal dysfunction, cirrhosis, septic shock, or those receiving a loading dose. Results: Of 248 patients included, 90% had a documented fungal infection or received empiric therapy for suspected invasive candidiasis. In patients receiving &lt;6 mg\/kg of fluconazole, 55% (110\/199) met DILIN criteria versus 46.9% (23\/49) in the \u2a7e6 mg\/kg cohort ( P = .20). Only 14.5% of patients meeting DILIN criteria also met the definition for hepatocellular damage. Weight-based fluconazole dose and creatinine clearance &lt;50 mL\/min were not independent risk factors for meeting DILIN criteria. However, 77.3% of patients with cirrhosis met DILIN criteria (OR 4.84 [95% confidence interval, CI, 2.61-9.28]) and 76.3% with septic shock met DILIN criteria (OR 4.56 [95% CI, 2.44-8.88]). Conclusion: Weight-based fluconazole dosing did not affect the number of critically ill recipients who met DILIN criteria. However, DILIN criteria may overestimate the incidence of fluconazole-associated liver injury in critically ill patients.<\/jats:p>","DOI":"10.1177\/0018578718802583","type":"journal-article","created":{"date-parts":[[2018,9,29]],"date-time":"2018-09-29T08:00:08Z","timestamp":1538208008000},"page":"378-384","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Critically Ill Recipients of Weight-Based Fluconazole Meeting Drug-Induced Liver Injury Network Criteria"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4190-8800","authenticated-orcid":false,"given":"Merlyn","family":"Joseph","sequence":"first","affiliation":[{"name":"Irma Lerma Rangel College of Pharmacy, Texas A&M University, Houston, TX, USA"},{"name":"South Texas Veterans Health Care System, Audie L. Murphy VA Hospital, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Brady","sequence":"additional","affiliation":[{"name":"University Hospital, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Attridge","sequence":"additional","affiliation":[{"name":"South Texas Veterans Health Care System, Audie L. Murphy VA Hospital, San Antonio, TX, USA"},{"name":"Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Cota","sequence":"additional","affiliation":[{"name":"Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8489-7836","authenticated-orcid":false,"given":"Cheryl","family":"Horlen","sequence":"additional","affiliation":[{"name":"Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Lusk","sequence":"additional","affiliation":[{"name":"Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA"},{"name":"University of Texas Health San Antonio, San Antonio, TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2162-3285","authenticated-orcid":false,"given":"Rebecca L.","family":"Attridge","sequence":"additional","affiliation":[{"name":"Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA"},{"name":"University of Texas Health San Antonio, San Antonio, TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,9,29]]},"reference":[{"key":"bibr1-0018578718802583","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-12-200212170-00007"},{"key":"bibr2-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.09.011"},{"key":"bibr3-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.03.006"},{"key":"bibr4-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411173312001"},{"key":"bibr5-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1086\/374850"},{"key":"bibr6-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67490."},{"key":"bibr7-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/23.5.964"},{"key":"bibr8-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066906."},{"key":"bibr9-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/14.Supplement_1.S161"},{"issue":"2","key":"bibr10-0018578718802583","first-page":"170","volume":"6","author":"Song JC","year":"2005","journal-title":"Curr Opin Investig Drugs"},{"key":"bibr11-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1086\/431586"},{"key":"bibr12-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1086\/596757"},{"key":"bibr13-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01657-09"},{"key":"bibr14-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000208"},{"key":"bibr15-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318266c6df"},{"key":"bibr16-0018578718802583","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1365"}],"container-title":["Hospital Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018578718802583","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0018578718802583","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018578718802583","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:38:37Z","timestamp":1777451917000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0018578718802583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,29]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1177\/0018578718802583"],"URL":"https:\/\/doi.org\/10.1177\/0018578718802583","relation":{},"ISSN":["0018-5787","1945-1253"],"issn-type":[{"value":"0018-5787","type":"print"},{"value":"1945-1253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,29]]}}}