An Observational Study of the Efficacy and Safety of Voriconazole in a Real-Life Clinical Setting

Abstract

An observational retrospective study in patients treated with voriconazole was made to evaluate outcomes, safety, drug interactions and characteristics of the treatment. A total of 96 patients were included. In 78.12%, at least one inducer or enzyme inhibitor was detected. The most frequently observed potential interaction was the simultaneous administration of omeprazole. A large number of patients were concurrently treated with corticosteroids. The simultaneous administration of drugs acting as CYP450 enzyme inhibitors was associated with a higher risk of toxicity while concomitant administration of corticosteroids seemed a protective factor. Our study is one of the few ones, which evaluate the use of voriconazole in a real life clinical setting. We demonstrate the wide variety of strategies in the voriconazole using and the large number of dugs that are susceptible to pharmacokinetic interactions. This study reinforces the need to implement voriconazole pharmacokinetic monitoring in order to optimize antifungal treatment.

Keywords:

• Voriconazole
• Fungal infections
• Safety
• Drug interactions
• Antifungal treatment

Notes on contributors

Sara Blanco-Dorado, pharmacist at the Department of Pharmacy and at the Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute, Santiago de Compostela.

Cristina Cea-Arestín, pharmacist at the Department of Clinical Analysis, University Hospital Vall D'Hebron.

Alba González Carballo, pharmacist at the Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela.

Ana Latorre-Pellicer, geneticist at the Medicina Xenómica Group, University Clinical Hospital of Santiago de Compostela.

Olalla Maroñas Amigo, geneticist at the Medicina Xenómica Group, University Clinical Hospital of Santiago de Compostela.

Gema Barbeito Castiñeiras, microbiologist at the Microbiology Department, University Clinical Hospital of Santiago de Compostela.

María Luisa Pérez del Molino Bernal, microbiologist at the Microbiology Department, University Clinical Hospital of Santiago de Compostela.

Manuel Campos-Toimil, pharmacist at the Department of Chronic Diseases, Center for Research in Molecular Medicine and Chronic Diseases, University Clinical Hospital of Santiago de Compostela.

Anxo Fernández-Ferreiro, pharmacist at the Department of Pharmacy and at the Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute, Santiago de Compostela.

María J Lamas, pharmacist. Head of Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute, Santiago de Compostela.