PMID- 36636370
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230115
IS  - 1178-6973 (Print)
IS  - 1178-6973 (Electronic)
IS  - 1178-6973 (Linking)
VI  - 16
DP  - 2023
TI  - Is Halving Maintenance of Voriconazole Safe and Efficient in Patients Suffering 
      from Invasive Fungal Infections with Serious Hepatic Dysfunction?
PG  - 1-8
LID - 10.2147/IDR.S390026 [doi]
AB  - BACKGROUND: There is a wide debate about the efficacy and safety of voriconazole 
      in patients with impaired hepatic function at Child-Pugh C level. OBJECTIVE: The 
      purpose of this study was to investigate the safety and efficacy between the two 
      groups treated with different dosages of voriconazole (400mg/day vs 200mg/day) in 
      the treatment of invasive fungal infections (IFIs) in patients with hepatic 
      dysfunction. METHODS: A retrospective study enrolling patients with hepatic 
      dysfunction receiving intravenous voriconazole for IFIs from January 1st, 2017, 
      to December 30th, 2021 was conducted. Patients were enrolled in the 400mg per day 
      dose group and 200mg per day dose group. In patients with the same degree of 
      hepatic impairment, factors affecting prognosis were screened and differences in 
      steady-state blood trough concentrations (C(min)) of voriconazole, positive G/GM 
      tests and adverse effects (AEs) were compared between the two groups described 
      above. RESULTS: In total, 308 patients with IFIs were enrolled. For Child-Pugh C 
      class, patients receiving the halved maintenance dose had a lower C(min) and AEs 
      rate but higher recovered rate compared to those receiving maintenance dose, and 
      significant predictors of recovery were dosage (OR, 5.131; 95% CI, 1.599-16.464; 
      p = 0.006) and diabetes (OR, 0.111; 95% CI, 0.020-0.597; p = 0.010). For patients 
      of Child-Pugh A & B class, chronic liver disease (OR, 0.334; 95% CI, 0.159-0.704; 
      p = 0.004) was a prognosis-related factor. CONCLUSION: Halving maintenance dose 
      ensure the efficacy and safety of voriconazole in patients suffering from 
      invasive fungal infections with serious hepatic dysfunction.
CI  - (c) 2023 Cai et al.
FAU - Cai, Xuezhou
AU  - Cai X
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
AD  - Department of Pharmacy, Xianning Central Hospital, Hubei University of Science 
      and Technology, Xianning, People's Republic of China.
FAU - Li, Wei
AU  - Li W
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
FAU - Yang, Jian
AU  - Yang J
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
AD  - Department of Pharmacy, General Hospital of Central Theater Command of Chinese 
      People's Liberation Army, Wuhan, People's Republic of China.
FAU - Wu, Guangjie
AU  - Wu G
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
FAU - Song, Jianxin
AU  - Song J
AD  - Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, 
      Huazhong University of Science and Technology, Wuhan, People's Republic of China.
FAU - Gong, Xuepeng
AU  - Gong X
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
FAU - Liu, Dong
AU  - Liu D
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
FAU - He, Yan
AU  - He Y
AUID- ORCID: 0000-0003-2836-1767
AD  - Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20230105
PL  - New Zealand
TA  - Infect Drug Resist
JT  - Infection and drug resistance
JID - 101550216
PMC - PMC9830075
OTO - NOTNLM
OT  - Child-Pugh
OT  - hepatic dysfunction
OT  - invasive fungal infections
OT  - through concentration
OT  - voriconazole
COIS- The authors report no conflicts of interest in this work.
EDAT- 2023/01/14 06:00
MHDA- 2023/01/14 06:01
PMCR- 2023/01/05
CRDT- 2023/01/13 02:01
PHST- 2022/10/13 00:00 [received]
PHST- 2022/12/28 00:00 [accepted]
PHST- 2023/01/13 02:01 [entrez]
PHST- 2023/01/14 06:00 [pubmed]
PHST- 2023/01/14 06:01 [medline]
PHST- 2023/01/05 00:00 [pmc-release]
AID - 390026 [pii]
AID - 10.2147/IDR.S390026 [doi]
PST - epublish
SO  - Infect Drug Resist. 2023 Jan 5;16:1-8. doi: 10.2147/IDR.S390026. eCollection 
      2023.