Related Experiment Video
Updated: Mar 18, 2026
High-throughput Fluorometric Measurement of Potential Soil Extracellular Enzyme Activities
Published on: November 15, 2013
[Not Available]
Marie Charles1, Chantal Le Guellec2, Damien Richard1
1Service de Pharmacologie, Hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
Abstract:
Itraconazole is a triazole antifungal agent that is active against Aspergillus, histoplasmosis, and rare fungal infections. Itraconazole exhibit marked variability in drug concentration as a result of inconsistent absorption, metabolism, or interaction with concomitant medications. Preclinical and clinical data have exhibited a relationship between serum concentrations and treatment efficacy or toxicity, thus therapeutic drug monitoring (TDM) of itraconazole is largely used to optimise therapy. The analysis of bibliographic data demonstrate that, even if the utility of itraconazole's TDM has not been proved by randomized controlled trial or pharmacoeconomics studies, it could be useful for managing an absence of response or a drug-drug interactions, or interpreting an adverse effect. However, the interest of this monitoring was proved only in some populations of patients (neutropenics or AIDS patients) so its level of proof varies between levels "potentially useful" and "recommended".
Insights
Therapeutic drug monitoring (TDM) of itraconazole, an antifungal, may help optimize treatment by managing response, interactions, or toxicity. Its utility is most proven in specific patient groups like neutropenics or AIDS patients.
Area of Science:
- Pharmacology and Mycology
- Clinical Pharmacy and Therapeutics
Context:
- Itraconazole, a triazole antifungal, demonstrates broad-spectrum activity against fungi like Aspergillus and agents causing histoplasmosis.
- Significant inter-individual variability in itraconazole serum concentrations arises from absorption, metabolism, and drug-drug interactions.
- Preclinical and clinical evidence links itraconazole concentrations to treatment outcomes, including efficacy and toxicity.
Purpose:
- To evaluate the utility and evidence level for therapeutic drug monitoring (TDM) of itraconazole.
- To assess the role of TDM in optimizing itraconazole therapy, particularly in managing treatment response, drug interactions, and adverse effects.
Summary:
- Bibliographic data analysis suggests itraconazole TDM can be beneficial for managing treatment non-response, drug-drug interactions, or adverse events.
- While not definitively proven by randomized controlled trials or pharmacoeconomic studies, TDM aids in interpreting clinical situations.
- The evidence supporting itraconazole TDM is strongest in specific populations, such as neutropenic patients and those with AIDS, with varying levels of recommendation.
Impact:
- Highlights the potential clinical value of itraconazole TDM in personalized medicine for fungal infections.
- Identifies specific patient groups and clinical scenarios where itraconazole TDM is most indicated.
- Suggests a need for further research, potentially including randomized controlled trials, to solidify the evidence base for itraconazole TDM.
