Voriconazole-refractory invasive aspergillosis
The Korean Journal of Internal Medicine
;
: 805-812, 2017.
Article
in English
| WPRIM
| ID: wpr-151271
ABSTRACT
Invasive aspergillosis (IA) is one of the most common life-threatening complications in immunocompromised patients. Voriconazole is currently the drug of choice for IA treatment. However, some patients with IA suffer clinical deterioration despite voriconazole therapy. Management of voriconazole-refractory IA remains challenging; no useful recommendations have yet been made. Voriconazole-refractory IA can be further categorized as disease attributable to misdiagnosis or co-infection with another mold; inadequate blood voriconazole blood; inadequate tissue drug concentrations attributable to angioinvasion; immune reconstitution inflammatory syndrome; or infection with voriconazole-resistant Aspergillus. Hence, when encountering a case of voriconazole-refractory IA, it is necessary to schedule sequential tests to decide whether medical treatment or surgical intervention is appropriate; to adjust the voriconazole dose via drug monitoring; to seek CYp2c19 polymorphisms; to monitor serum galactomannan levels; and to examine the drug susceptibility of the causative Aspergillus species.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Appointments and Schedules
/
Aspergillosis
/
Aspergillus
/
Immunocompromised Host
/
Drug Monitoring
/
Diagnostic Errors
/
Immune Reconstitution Inflammatory Syndrome
/
Coinfection
/
Voriconazole
/
Cytochrome P-450 CYP2C19
Type of study:
Diagnostic study
/
Practice guideline
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2017
Type:
Article
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