Administration of Voriconazole in Patients With Renal Dysfunction

Abstract

Voriconazole route of administration and baseline renal function were not predictors of worsening renal dysfunction on days 3, 7, and EOT. Underlying disease, baseline liver impairment, and concomitant administration of other drugs (eg, penicillins, fluoroquinolones, immunosuppressants) were the strongest predictors of renal dysfunction.

Worsening renal function in patients with baseline renal impairment treated with intravenous voriconazole: A systematic review

“…Unfortunately, a standardised definition of worsening renal function was not used in all of these studies. Only two studies [20,23] utilised the RIFLE criteria, whilst others employed trends in CL Cr or SCr, or their own definitions for renal toxicity. Owing to this heterogeneity in definition, comparison of incidence of worsening renal function between studies is difficult.…”

“…This study was funded by a grant from Pfizer and several of the authors have received grants, been on advisory boards or been consultants for Pfizer. Despite these limitations, this study adds to the growing body of evidence suggesting that receipt of IVV is not an independent risk factor for worsening renal impairment [23].…”

“…As detailed in Section 3.3, Neofytos et al [23] did not identify receipt of IVV to be associated with an increased risk of worsening renal function compared with receipt of POV in patients with CL Cr < 50 mL/min. Whilst only 89 patients were included in this comparison, this study suggests that the incidence of worsening renal function is similar regardless of method of receipt of voriconazole [23].…”

“…In 2012, Neofytos et al [23] performed a retrospective, single cohort study of adult patients receiving ≥3 days of voriconazole. Those receiving oral voriconazole (POV) with a CL Cr > 50 mL/min were excluded, as were those receiving RRT.…”

Update on lung transplantation: programmes, patients and prospects

“…The current prophylactic and treatment antifungal drug of choice for Aspergillus is voriconazole which has proven efficacy but significant bioavailability, drug-drug interaction and toxicity issues making therapeutic drug monitoring very important and useful [266][267][268][269][270][271][272][273]. A prophylaxis strategy is recommended when there is a high pre-test probability of Aspergillus being present and potentially causing serious complications as in LTR with Aspergillus in the sputum just prior to transplant surgery.…”