AI Article Synopsis
- The study evaluated the oral bioavailability of voriconazole by measuring serum concentrations in patients who switched from intravenous to oral administration at Gifu University Hospital from 2011 to 2018.
- Results showed that serum voriconazole levels significantly decreased after the switch, with concentrations averaging 2.5 µg/mL for oral versus 3.3 µg/mL for intravenous.
- The findings suggest that individual variations exist, and serum concentration measurements should be conducted for dose adjustments when switching to the oral form.
Article Abstract
What Is Known And Objective: While bioavailability of oral voriconazole is known to be >90%, several reports have observed much lower oral bioavailability. The aim of the present study was to assess the oral bioavailability of voriconazole in clinical use by evaluating the change in serum voriconazole concentration in patients who received intravenous-to-oral switch therapy with the same dose of voriconazole.
Methods: A single-centre, retrospective cohort study was conducted at the 614-bed Gifu University Hospital in Japan. Patients who received intravenous-to-oral switch therapy with the same dose of voriconazole between 1 January 2011 and 31 December 2018 were enrolled in the present study. We evaluated changes in serum voriconazole concentration before and after switch therapy.
Results: Voriconazole trough concentrations significantly decreased following oral compared to intravenous treatment (2.5 ± 1.5 µg/mL vs 3.3 ± 2.0 µg/mL, p = 0.021). The median change rate of serum concentration by switching the route of administration was 82.7%, with wide inter-individual variability (range 27.2-333.3%). Further, concomitant glucocorticoid administration was a significant protective factor for reducing serum concentration (OR 0.16, 95% CI 0.03-0.79, p = 0.025).
What Is New And Conclusion: Switching from intravenous to oral treatment resulted in a significant decline in voriconazole trough concentrations with wide inter-individual variability. Therefore, measurement of serum concentration for dose adjustment should be performed after switching to the oral form.
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| http://dx.doi.org/10.1111/jcpt.13352 | DOI Listing |
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