Voriconazole as an alternative oral treatment in fluconazole-resistant urinary candidiasis - 31/08/24
, Audrey Le Bot b, David Luque Paz b, Marie-Clémence Verdier a, c, Hélène Guegan c, d, Jean-Pierre Gangneux c, d, Eric Bellissant a, c, Florian Lemaitre a, cHighlights |
• | The median voriconazole concentration in urine was 1.7 mg/L (range: 0.3–12.6). |
• | Measures of voriconazole concentrations in plasma and urine were highly correlated. |
• | Voriconazole shows promise as an alternative treatment for fluconazole-resistant urinary candidiasis. |
Abstract |
Objectives |
This study aims to assess the urinary diffusion and clinical effectiveness of voriconazole in patients with fluconazole-resistant urinary candidiasis.
Patients and methods |
In this prospective pilot study, we utilized a validated chromatography method to measure voriconazole in urine over a 12-hour period between two administrations of the drug and in plasma at trough.
Results |
Thirty-five patients, including five with fluconazole-resistant urinary candidiasis, were included. Urine and plasma voriconazole concentrations, mean 1.7 mg/L (range: 0.3–12.6) and mean 2.0 mg/L (range: 0.1–11.1) respectively, exhibited a strong correlation (R2 = 0.88). None of the five patients treated for candidiasis experienced clinical or microbiological failure following treatment, with urine concentrations ranging from 0.5 to 2.7 mg/L.
Conclusions |
The urinary diffusion of voriconazole resulted in drug exposure above the target minimum inhibitory concentration (MIC) in the five patients treated for voriconazole-susceptible Candida strains in urine. Therapeutic drug monitoring may allow optimize in situ concentrations.
Le texte complet de cet article est disponible en PDF.Keywords : Antifungal, Fluconazole-resistance, Therapeutic drug monitoring, Urinary candidiasis, Voriconazole
Plan
Vol 54 - N° 6
Article 104955- septembre 2024 Retour au numéro
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