{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:34:19Z","timestamp":1786365259599,"version":"build-2736575974"},"reference-count":10,"publisher":"The Pediatric Pharmacy Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    Neonatal invasive fungal infections (IFI) from\n                    <jats:italic>Aspergillus<\/jats:italic>\n                    species are increasing in frequency. While voriconazole remains the antifungal of choice for treatment in many patient populations, several pharmacokinetic challenges affect dosing of voriconazole in premature neonates. Further complicating voriconazole use are the unknown implications of drug interactions in the preterm population. We report a case of voriconazole use in a neonate for the treatment of cutaneous\n                    <jats:italic>Aspergillosis<\/jats:italic>\n                    with variable serum voriconazole concentrations, reflecting a suspected drug interaction with dexamethasone. Serum voriconazole concentrations were initially subtherapeutic despite multiple dose escalations, then unexpectedly increased to supratherapeutic range as a concomitant dexamethasone course was tapered. Re-initiation of voriconazole after discontinuation of dexamethasone resulted in supratherapeutic concentrations that were discordant from previous serum concentrations on the same voriconazole dose while receiving dexamethasone. This is the first report of a potential drug interaction between voriconazole and a corticosteroid in a preterm neonate, highlighting the importance of drug interactions in voriconazole dosing evaluation and monitoring in this population.\n                  <\/jats:p>","DOI":"10.5863\/jppt-25-00085","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:26:27Z","timestamp":1786364787000},"page":"553-556","source":"Crossref","is-referenced-by-count":0,"title":["Voriconazole and Dexamethasone Drug Interaction in a Premature Neonate"],"prefix":"10.5863","volume":"31","author":[{"given":"Caren J.","family":"Liviskie","sequence":"first","affiliation":[{"name":"Department of Pharmacy (CJL, CRL, CCM), St. Louis Children\u2019s Hospital, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine R.","family":"Lockowitz","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (CJL, CRL, CCM), St. Louis Children\u2019s Hospital, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"McPherson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (CJL, CRL, CCM), St. Louis Children\u2019s Hospital, St. Louis, MO"},{"name":"Department of Pediatrics (CCM, MMR, DAH), WashU Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa M.","family":"Riley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (CCM, MMR, DAH), WashU Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Hunstad","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (CCM, MMR, DAH), WashU Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"2","key":"JPPT-25-00085-b01","series-title":"Pediatr Res","first-page":"404","article-title":"Invasive fungal infections in neonates: a review","volume":"91","author":"Weimer","year":"2022","unstructured":"Weimer KED, Smith PB, Puia-Dumitrescu M, Aleem S. Invasive fungal infections in neonates: a review. Pediatr Res. 2022;91(2):404\u2013412."},{"issue":"4","key":"JPPT-25-00085-b02","series-title":"Pediatr Infect Dis J","first-page":"352","article-title":"Molds and more: rare fungal infections in preterm infants <24 weeks of gestation","volume":"41","author":"Mehler","year":"2022","unstructured":"Mehler K, Cornely O, Seifert H, et al. Molds and more: rare fungal infections in preterm infants <24 weeks of gestation. Pediatr Infect Dis J. 2022;41(4):352\u2013357."},{"issue":"9","key":"JPPT-25-00085-b03","series-title":"Clin Microbiol Infect","first-page":"1096","article-title":"ESCMID-ECMM guideline: diagnosis and management of invasive aspergillosis in neonates and children","volume":"25","author":"Warris","year":"2019","unstructured":"Warris A, Lehrnbecher T, Roilides E, et al. ESCMID-ECMM guideline: diagnosis and management of invasive aspergillosis in neonates and children. Clin Microbiol Infect. 2019;25(9):1096\u20131113."},{"issue":"3","key":"JPPT-25-00085-b04","series-title":"J Clin Pharmacol","first-page":"266","article-title":"Meta-analysis of hepatic cytochrome P450 ontogeny to underwrite the prediction of pediatric pharmacokinetics using physiologically based pharmacokinetic modeling","volume":"56","author":"Upreti","year":"2016","unstructured":"Upreti VV, Wahlstrom JL. Meta-analysis of hepatic cytochrome P450 ontogeny to underwrite the prediction of pediatric pharmacokinetics using physiologically based pharmacokinetic modeling. J Clin Pharmacol. 2016;56(3):266\u2013283."},{"issue":"4","key":"JPPT-25-00085-b05","series-title":"Ann Pharmacother","first-page":"674","article-title":"Proposal for a new tool to evaluate drug interaction cases","volume":"41","author":"Horn","year":"2007","unstructured":"Horn JR, Hansten PD, Chan LN.  Proposal for a new tool to evaluate drug interaction cases. Ann Pharmacother. 2007;41(4):674\u2013680."},{"issue":"3","key":"JPPT-25-00085-b06","series-title":"Pediatr Infect Dis J","first-page":"227","article-title":"Rare infant case of pulmonary aspergilloma highlighting common challenges with voriconazole dosing","volume":"40","author":"Abo","year":"2021","unstructured":"Abo YN, Gwee A, Osowicki J. Rare infant case of pulmonary aspergilloma highlighting common challenges with voriconazole dosing. Pediatr Infect Dis J. 2021;40(3):227\u2013230."},{"key":"JPPT-25-00085-b07","series-title":"Front Pharmacol","first-page":"666296","article-title":"Interactive effects of glucocorticoids and cytochrome P450 polymorphisms on the plasma trough concentrations of voriconazole","volume":"12","author":"Jia","year":"2021","unstructured":"Jia SJ, Gao KQ, Huang PH, et al. Interactive effects of glucocorticoids and cytochrome P450 polymorphisms on the plasma trough concentrations of voriconazole. Front Pharmacol. 2021;12:666296."},{"issue":"6","key":"JPPT-25-00085-b08","series-title":"Ther Drug Monit","first-page":"866","article-title":"Factors associated with voriconazole concentration in pediatric patients","volume":"42","author":"Kang","year":"2020","unstructured":"Kang S, Yee J, Kim JY, et al. Factors associated with voriconazole concentration in pediatric patients. Ther Drug Monit. 2020;42(6):866\u2013871."},{"issue":"3","key":"JPPT-25-00085-b09","series-title":"Indian Pediatr","first-page":"236","article-title":"Voriconazole in newborns","volume":"45","author":"Kohli","year":"2008","unstructured":"Kohli V, Taneja V, Sachdev P, Joshi R. Voriconazole in newborns. Indian Pediatr.  2008;45(3):236\u2013238."},{"issue":"6","key":"JPPT-25-00085-b10","series-title":"Pharmacotherapy","first-page":"893","article-title":"Intravenous voriconazole therapy in a preterm infant","volume":"25","author":"Muldrew","year":"2005","unstructured":"Muldrew KM, Maples HD, Stowe CD, Jacobs RF. Intravenous voriconazole therapy in a preterm infant. Pharmacotherapy. 2005;25(6):893\u2013898."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/31\/4\/article-p553.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/31\/4\/article-p553.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/31\/4\/article-p553.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:26:27Z","timestamp":1786364787000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/31\/4\/article-p553.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":10,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.5863\/jppt-25-00085","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}