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Related Experiment Videos

Voriconazole.

LilyAnn Jeu1, Frank J Piacenti, Aleksandr G Lyakhovetskiy

  • 1Pharmacy Service, Veterans Affairs Medical Center, Bronx, New York 10468, USA.

Clinical Therapeutics
|July 18, 2003
PubMed
Summary

Voriconazole is an effective antifungal for invasive aspergillosis and candidiasis, especially when other treatments fail. Dose adjustments are needed for hepatic dysfunction or drug interactions.

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Area of Science:

  • Mycology
  • Pharmacology
  • Infectious Diseases

Background:

  • Increasing resistance and intolerance to existing antifungal agents.
  • Voriconazole is a broad-spectrum azole antifungal derived from fluconazole.
  • Indicated for invasive aspergillosis and serious fungal infections in patients refractory to other therapies.

Purpose of the Study:

  • Review pharmacologic and pharmacokinetic properties of voriconazole.
  • Evaluate the clinical usefulness of voriconazole.
  • Assess voriconazole's efficacy and safety compared to existing antifungals.

Main Methods:

  • Literature search of MEDLINE, Iowa Drug Information Service, and International Pharmaceutical Abstracts (1966-2002).
  • Inclusion of meeting abstracts from IDSA and ICAAC (1996-2002).
  • Search terms included voriconazole and UK-109,495.

Main Results:

  • Voriconazole demonstrated comparable efficacy to amphotericin B for invasive aspergillosis and febrile neutropenia fungal infections.
  • Efficacy against oropharyngeal and esophageal candidiasis was similar to fluconazole.
  • Potential utility against fluconazole-resistant Candida strains; common adverse effects include visual disturbances, skin reactions, and elevated hepatic enzymes.

Conclusions:

  • Voriconazole is a viable alternative for patients with resistance or intolerance to conventional antifungals.
  • Dose adjustments are crucial for patients with hepatic dysfunction or those on interacting medications.
  • Consider oral voriconazole for patients with impaired renal function (creatinine clearance <50 mL/min).

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