ABSTRACT
In this study we present the results of a therapeutic drug monitoring retrospective analysis involving 14 patients with several underlying diseases who were receiving voriconazole for the treatment of fungal infections. A simple high performance liquid chromatography assay with ultraviolet detection was used in the drug monitoring. We report here that serum concentrations were highly variable and unpredictable in most patients. We also found that lack of response was more frequent in patients with levels persistently lower than 1 mg/l. The number of samples with voriconazole concentrations below 1 mg/l was significantly higher in patients who exhibited therapeutic failures (88% versus 27%; P < 0.001). In addition, the period of time in which voriconazole concentrations were maintained below 1 mg/l was slightly higher in patients in the failure group. We suggest that serum concentration should be individually quantified for patients receiving voriconazole therapy. Further prospective studies are needed to clarify the potential benefit of the individualization of treatment.
Subject(s)
Antifungal Agents/administration & dosage , Antifungal Agents/pharmacokinetics , Pyrimidines/administration & dosage , Pyrimidines/pharmacokinetics , Serum/chemistry , Triazoles/administration & dosage , Triazoles/pharmacokinetics , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Chromatography, High Pressure Liquid/methods , Drug Monitoring/methods , Female , Humans , Male , Middle Aged , Mycoses/drug therapy , Retrospective Studies , Time Factors , Voriconazole , Young AdultSubject(s)
Anti-Infective Agents, Local/adverse effects , Bacteremia/epidemiology , Burkholderia Infections/epidemiology , Burkholderia cepacia/isolation & purification , Chlorhexidine/adverse effects , Cross Infection/epidemiology , Aged , Aged, 80 and over , Ambulatory Care Facilities , Bacteremia/microbiology , Bacteremia/transmission , Burkholderia Infections/microbiology , Burkholderia Infections/transmission , Cross Infection/microbiology , Cross Infection/transmission , Disease Outbreaks , Drug Contamination , Female , Humans , Male , Renal Dialysis , Spain/epidemiology , Water MicrobiologySubject(s)
Brucellosis , Adult , Animals , Animals, Domestic , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/therapeutic use , Brucellosis/diagnosis , Brucellosis/drug therapy , Brucellosis/epidemiology , Brucellosis/transmission , Brucellosis/veterinary , Drug Evaluation , Female , Humans , Immunologic Tests , Incidence , Infant , Infant, Newborn , Male , Pregnancy , Spain/epidemiology , ZoonosesSubject(s)
Anti-Bacterial Agents/pharmacology , Campylobacter fetus/drug effects , Nalidixic Acid/analogs & derivatives , Quinolines/pharmacology , Salmonella/drug effects , Shigella/drug effects , Ciprofloxacin , Gastroenteritis/microbiology , Humans , Microbial Sensitivity Tests , Nalidixic Acid/pharmacology , NorfloxacinABSTRACT
The in vitro synergistic activity of N-formimidoyl thienamycin and amikacin was determined against gentamicin-resistant enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus aureus. N-Formimidoyl thienamycin showed synergism with amikacin against 19 of the gentamicin-resistant strains, 14 of the 49 strains of S. aureus, and only 1 strain of the 46 P. aeruginosa isolates.
Subject(s)
Amikacin/pharmacology , Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Kanamycin/analogs & derivatives , Staphylococcus aureus/drug effects , Thienamycins/pharmacology , Drug Resistance, Microbial , Drug Synergism , Enterobacteriaceae/drug effects , Gentamicins/pharmacology , Imipenem , Pseudomonas aeruginosa/drug effectsABSTRACT
IN vitro susceptibilities of 98 isolates of Brucella melitensis to N-formimidoyl thienamycin, tetracycline, co-trimoxazole, rifampin, and cefoxitin were determined. N-Formimidoyl thienamycin showed good activity which was similar to those of tetracycline and rifampin and different from that of the other beta-lactam antibiotic tested (cefoxitin), which showed poor activity. Co-trimoxazole showed good activity.
