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Voriconazole in childrens

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https://www.readbyqxmd.com/read/29062248/evaluation-of-candida-species-and-antifungal-susceptibilities-among-children-with-invasive-candidiasis
#1
Murat Sütçü, Manolya Acar, Gonca Erköse Genç, İlknur Kökçü, Hacer Aktürk, Gürkan Atay, Selda Hançerli Törun, Nuran Salman, Zayre Erturan, Ayper Somer
AIM: Non-albicans Candida species and resistant microorganisms have been more commonly isolated in invasive candidiasis in recent years. The aim of this study was to evaluate the distrubution of Candida spp and antifungal resistance in our clinic. MATERIAL AND METHODS: Fifty-four Candida isolates and antifungal susceptibility results obtained from patients diagnosed as having invasive candidiasis between December 2012 and June 2016 were included. Clinical and laboratory data were retrospectively analyzed...
September 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/29043231/voriconazole-plus-caspofungin-for-treatment-of-invasive-fungal-infection-in-children-with-acute-leukemia
#2
Kyu Ho Lee, Young Tae Lim, Jeong Ok Hah, Yu Kyung Kim, Chae Hoon Lee, Jae Min Lee
BACKGROUND: Invasive fungal infections (IFIs) are a life-threatening problem in immunocompromised patients. Despite timely diagnosis and appropriate antifungal therapy, clinical outcomes of IFIs remain unsatisfactory, necessitating treatment with a combination of antifungal agents. Therefore, childhood leukemic patients treated with voriconazole plus caspofungin were evaluated for the safety and efficacy of the combination antifungal therapy to treat IFIs. METHODS: In this retrospective study, medical records were retrieved for patients admitted to the Pediatric Department of Yeungnam University Hospital, Daegu, South Korea, between April 2009 and May 2013...
September 2017: Blood Research
https://www.readbyqxmd.com/read/29038273/pharmacokinetic-modelling-of-voriconazole-to-develop-an-alternative-dosing-regimen-in-children
#3
Silke Gastine, Thomas Lehrnbecher, Carsten Müller, Fedja Farowski, Peter Bader, Judith Ullmann-Moskovits, Oliver A Cornely, Andreas H Groll, Georg Hempel
Background. The pharmacokinetic variability of voriconazole in immunocompromised children is high and adequate exposure, particularly in the first days of therapy, is uncertain.Methods A population pharmacokinetic model was developed to explore VCZ exposure in plasma after alternative dosing regimens. Concentration data were obtained from a pediatric phase II study. Non-linear mixed effects modelling was used to develop the model. Monte Carlo simulations were performed to test an array of three times daily (TID) intravenous dosing regimens in children 2 to 12 years of age...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28992093/voriconazole-treatment-in-adults-and-children-with-hematological-diseases-can-it-be-used-without-measurement-of-plasma-concentration
#4
Corrado Girmenia, Luciana Annino, Alice Bertaina, Benedetta Mariotti, Désirée Caselli, Rosa Fanci, Walter Barberi, Francesco Marchesi, Alessandra Carotti, Antonella Ferrari, Elisabetta Cerchiara, Luca Cupelli, Francesco Arcioni, Michela Ribersani, Anna Proia, Claudio Cartoni, Katia Girardi, Adriano Venditti, Maria Iris Cassetta, Stefania Fallani, Andrea Novelli
Indication and timing of trough plasma-voriconazole (VCZ)-concentration (t-PVC) measurement during VCZ treatment is a debated issue. Patterns of t-PVC were prospectively evaluated in pediatric (50 courses) and adult (95 courses) hematologic patients. Efficacy patterns were defined: adequate, t-PVC always ≥1 mcg/ml; borderline, at least one t-PVC measurement <1 mcg/ml but median value of the measurements ≥1 mcg/ml; inadequate, median value of the measurements <1 mcg/ml. Toxicity patterns were defined: favorable, t-PVC always ≤5 mcg/ml; borderline, one or more t-PVC measurements >5 mcg/ml but median value of the measurements ≤5 mcg/ml; unfavorable, median value of the measurements >5 mcg/ml...
August 2, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28816795/voriconazole-antifungal-prophylaxis-in-children-with-malignancies-a-nationwide-study
#5
Zoi Dorothea Pana, Maria Kourti, Katerina Vikelouda, Antonia Vlahou, Nikolaos Katzilakis, Maria Papageorgiou, Dimitrios Doganis, Loizos Petrikkos, Anna Paisiou, Dimitrios Koliouskas, Antonios Kattamis, Eftichia Stiakaki, Maria Chatzistilianou, Helen Vasilatou-Kosmidis, Sophia Polychronopoulou, Stelios Grafakos, Emmanuel Roilides
BACKGROUND: Antifungal prophylaxis (AFP) is recommended in at-risk hematology-oncology patients. We evaluated the safety of AFP with voriconazole (VRC) in pediatric hematology/oncology patients. MATERIALS AND METHODS: A retrospective study of VRC AFP in children with malignancies hospitalized in all 7 Greek pediatric hematology/oncology centers during 2008 to 2012 was conducted. Patients' demographics, outcome, and adverse event (AE) data were recorded. RESULTS: Four hundred twenty-nine VRC AFP courses in 249 patients (median age 6 y, 55% boys) were studied...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28805964/therapeutic-drug-monitoring-of-voriconazole-for-treatment-and-prophylaxis-of-invasive-fungal-infection-in-children
#6
Sarah Allegra, Giovanna Fatiguso, Silvia De Francia, Fabio Favata, Elisa Pirro, Chiara Carcieri, Amedeo De Nicolò, Jessica Cusato, Giovanni Di Perri, Antonio D'Avolio
Voriconazole therapeutic drug monitoring is not consistently recommended due to its high interpatient and intrapatient variability. Here, we aimed to describe our experience with voriconazole for treatment and prophylaxis of invasive fungal infections in paediatric patients. A fully validated high-performance liquid chromatography-mass spectrometry method was used to quantify voriconazole concentration in plasma, at the end of dosing interval. A high interindividual variability was shown. We enrolled 237 children, 83 receiving intravenous and 154 oral voriconazole...
August 14, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28510690/trichosporonosis-in-pediatric-patients-with-a-hematologic-disorder
#7
Catherine E Foster, Morven S Edwards, Julienne Brackett, Deborah A Schady, C Mary Healy, Carol J Baker
Background.: Trichosporonosis is an emerging and often fatal opportunistic fungal infection in immunocompromised patients, particularly those with hematologic malignancy, but data in children are lacking. Methods.: We report here 3 cases of invasive infection caused by Trichosporon asahii in pediatric patients with acute lymphoblastic leukemia at Texas Children's Hospital in Houston, Texas. We also conducted a literature review and identified 16 additional reports of pediatric patients with invasive T asahii infection and an underlying malignant or nonmalignant hematologic disorder...
May 16, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28407118/voriconazole-dosing-in-children-younger-than-3-years-undergoing-cancer-chemotherapy-or-hematopoietic-stem-cell-transplantation
#8
Shirley Qiong Yan, Brian Seyboth, Rachel Kobos, Anne Eaton, Susan K Seo, Nina Cohen
There are limited pediatric population pharmacokinetic data for voriconazole dosing, particularly in younger children. In a cohort of 34 patients younger than 3 years receiving voriconazole, the majority (n = 23, 68%) had a low initial serum concentration <1 mg/L. Among 23 children <2 years old, 19 (83%) had an initial trough <1 mg/L. There was large intra- and interindividual variability in trough levels. Dosing also varied from 3.3 to 19.6 mg/kg per dose. Only 2 of 34 patients had a documented adverse drug reaction attributable to voriconazole...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28394976/-drug-interaction-of-voriconazole-cyclosporine-in-children-undergoing-hematopoietic-stem-cell-transplantation-2013-2014
#9
Romina Valenzuela, Juan P Torres, Carolina Salas, Iván Gajardo, Julia Palma, Paula Catalán, M Elena Santolaya, Jorge Morales
BACKGROUND: Drug interactions (DI) in patients receiving hematopoietic stem cell transplantation (HSCT) are common and clinically significant, highlighting: anticonvulsants, voriconazole (VCZ) and cyclosporine (CsA), which require monitoring. OBJECTIVE: To describe the interactions between CsA-VCZ in children undergoing HSCT. METHODS: Retrospective, descriptive study in immunocompromised children hospitalized since January 2013 to December 2014 at Bone Marrow Transplant Unit, Hospital Dr...
February 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28306618/impact-of-the-cyp2c19-genotype-on-voriconazole-exposure-in-adults-with-invasive-fungal-infections
#10
Issam S Hamadeh, Kenneth P Klinker, Samuel J Borgert, Ashley I Richards, Wenhui Li, Naveen Mangal, John W Hiemenz, Stephan Schmidt, Taimour Y Langaee, Charles A Peloquin, Julie A Johnson, Larisa H Cavallari
OBJECTIVES: Voriconazole, a first-line agent for the treatment of invasive fungal infections (IFIs), is metabolized by CYP2C19. A significant proportion of patients fail to achieve therapeutic trough concentrations with standard weight-based voriconazole dosing, placing them at increased risk for treatment failure, which can be life threatening. We sought to test the association between the CYP2C19 genotype and subtherapeutic voriconazole concentrations in adults with IFIs. PATIENT AND METHODS: Adults receiving weight-based voriconazole dosing for the treatment of IFIs were genotyped for the CYP2C19*2, *3, and *17 polymorphisms, and CYP2C19 metabolizer phenotypes were inferred...
May 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28159657/dose-optimisation-of-voriconazole-with-therapeutic-drug-monitoring-in-children-a-single-centre-experience-in-china
#11
Liang Liu, Xing Zhou, Tingting Wu, Hongliang Jiang, Sitao Yang, Yang Zhang
The pharmacokinetic profile of voriconazole is highly variable, rendering inconsistent and/or inadequate dosing, especially in children <2 years old. A retrospective analysis was performed in children receiving voriconazole with at least one plasma trough level (Ctrough) monitored. Statistical analyses were performed to examine the dose-exposure relationship as well as other factors potentially affecting voriconazole Ctrough in children of different ages. A total of 107 paediatric patients were included, of whom 75 were <2 years old...
April 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#12
REVIEW
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic (PK) alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole is presented. PubMed (1966-July 2015) and Cochrane Library searches were performed using these key terms: children, pharmacokinetic, obesity, overweight, body mass index, ideal body weight, lean body weight, body composition, and specific antimicrobial drugs...
March 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27909942/experiment-design-for-nonparametric-models-based-on-minimizing-bayes-risk-application-to-voriconazole-formula-see-text
#13
David S Bayard, Michael Neely
An experimental design approach is presented for individualized therapy in the special case where the prior information is specified by a nonparametric (NP) population model. Here, a NP model refers to a discrete probability model characterized by a finite set of support points and their associated weights. An important question arises as to how to best design experiments for this type of model. Many experimental design methods are based on Fisher information or other approaches originally developed for parametric models...
April 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/27746090/-epidemiology-risk-factors-and-in-vitro-susceptibility-in-candidaemia-due-to-non-candida-albicans-species
#14
Elena M Marín Martínez, Ana Isabel Aller García, Estrella Martín-Mazuelos
BACKGROUND: Invasive fungal infection (IFI) has increased in recent years due to there being a greater number of risk factors. IFI caused by Candida is the most frequent, and although Candida albicans is the most isolated species, there is currently a decrease of C. albicans and an increase of other species of the genus. AIMS: To analyse the epidemiology, risk factors, and antifungal susceptibility of blood culture isolates of non-C.albicans Candida species in our hospital in the last 12years...
October 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/27548272/an-optimized-voriconazole-dosing-strategy-to-achieve-therapeutic-serum-concentrations-in-children-younger-than-2-years-old
#15
Tracy N Zembles, Nathan E Thompson, Peter L Havens, Bruce A Kaufman, Anna R Huppler
STUDY OBJECTIVE: To describe our experience with voriconazole in three patients younger than 2 years using an optimized dosing strategy for voriconazole that incorporates intensive therapeutic drug monitoring (TDM). DESIGN: Case series. SETTING: Large pediatric hospital. PATIENTS: Three patients younger than 2 years who received voriconazole therapy and had serum trough concentrations measured between January 1, 2010, and October 31, 2015...
October 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27355512/pharmacodynamic-studies-of-voriconazole-informing-the-clinical-management-of-invasive-fungal-infections
#16
REVIEW
Kathleen M Job, Jared Olson, Chris Stockmann, Jonathan E Constance, Elena Y Enioutina, Joseph E Rower, Matthew W Linakis, Alfred H Balch, Tian Yu, Xiaoxi Liu, Emily A Thorell, Catherine M T Sherwin
INTRODUCTION: Voriconazole is a broad-spectrum antifungal agent commonly used to treat invasive fungal infections (IFI), including aspergillosis, candidiasis, Scedosporium infection, and Fusarium infection. IFI often occur in immunocompromised patients, leading to increased morbidity and mortality. AREAS COVERED: The objective of this review is to summarize the pharmacodynamic properties of voriconazole and to provide considerations for potential optimal dosing strategies...
August 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27329132/prophylactic-administration-of-voriconazole-with-two-different-doses-for-invasive-fungal-infection-in-children-and-adolescents-with-acute-myeloid-leukemia
#17
Hirozumi Sano, Ryoji Kobayashi, Daiki Hori, Kenji Kishimoto, Daisuke Suzuki, Kazue Yasuda, Kunihiko Kobayashi
BACKGROUND: Pediatric patients under treatment for acute myeloid leukemia (AML) are at high risk for invasive fungal infection (IFI). We evaluated the efficacy of prophylactic administration of voriconazole (VRCZ) with two different doses. METHODS: Between October 2005 and June 2011, 17 children and adolescents (aged 0-20 years) undergoing chemotherapy for AML were prophylactically administered with 5 mg/kg/d of oral VRCZ. Furthermore, 22 AML patients (aged 0-19 years) were administered 10 mg/kg/d of oral VRCZ between July 2011 and December 2014...
June 2, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/27293256/chromoblastomycosis-associated-with-bone-and-central-nervous-involvement-system-in-an-immunocompetent-child-caused-by-exophiala-spinifera
#18
Sahana M Srinivas, Vykuntaraju K Gowda, S Mahantesh, Rajeshwari Mannapur, Sanjay K Shivappa
Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera...
May 2016: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/27226920/aspergillus-flavus-induced-brain-abscess-in-an-immunocompetent-child-case-report
#19
Nawal Al-Maskari, Ibrahim Hussain, Suleiman Jumaa, Essam A Al-Shail
Intracranial aspergillosis is an extremely rare manifestation of invasive aspergillosis in immunocompetent children and is associated with high morbidity and mortality. We report a 12-year-old immunocompetent male child who was referred to the King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, in May 2010 after a sudden-onset headache and loss of consciousness. Brain imaging revealed a large right space-occupying occipital lesion and the patient underwent a craniotomy and resection. Histopathology of the lesion revealed necrotising granulomatous fungal encephalitis with many hyphae engulfed by multinucleated giant histiocytes...
May 2016: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/27179818/pharmacokinetic-pharmacodynamic-analysis-of-voriconazole-against-candida-spp-and-aspergillus-spp-in-children-adolescents-and-adults-by-monte-carlo-simulation
#20
Gaoqi Xu, Liqin Zhu, Tingyue Ge, Shasha Liao, Na Li, Fang Qi
The objective of this study was to investigate the cumulative fraction of response of various voriconazole dosing regimens against six Candida and six Aspergillus spp. in immunocompromised children, immunocompromised adolescents, and adults. Using pharmacokinetic parameters and pharmacodynamic data, 5000-subject Monte Carlo simulations (MCSs) were conducted to evaluate the ability of simulated dosing strategies in terms of fAUC/MIC targets of voriconazole. According to the results of the MCSs, current voriconazole dosage regimens were all effective for children, adolescents and adults against Candida albicans, Candida parapsilosis and Candida orthopsilosis...
June 2016: International Journal of Antimicrobial Agents
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